| Date |
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| 04/20/2005 |
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INOCULATIONS:
THE TRUE WEAPONS OF MASS DESTRUCTION
CAUSING VIDS (VACCINE INDUCED DISEASES)
(AN EPIDEMIC OF GENOCIDE)
by Rebecca Carley, M.D.
Court Qualified Expert in VIDS and Legal Abuse Syndrome
January 2005 “One basic truth can be used as a foundation for a
mountain of lies, and if we dig down deep enough in the mountain of
lies, and bring out that truth, to set it on top of the mountain of
lies; the entire mountain of lies will crumble under the weight of that
one truth. And there is nothing more devastating to a structure of lies
than the revelation of the truth upon which the structure of lies was
built, because the shock waves of the revelation of the truth
reverberate, and continue to reverberate throughout the Earth for
generations to follow, awakening even those people who had no desire to
be awakened to the truth.” (by Delamar Duvaris as written in the
preface of “Behold the Pale Horse” by William Cooper). The basic truth
that served as the foundation for the mountain of lies known as
vaccinations was the observation that mammals which recover from
infection with microorganisms acquire natural immunity from further
infections. Whenever cytotoxic T cells (the little Pac man cells which
devour and neutralize viruses, bacteria, and cancer cells, thus
conferring cellular immunity and are also responsible for allograft
rejection) and B cells (antibody producing cells which confer humoral
immunity by circulating in the body’s fluids or “humors”, primarily
serum or lymph) are activated by various substances foreign to the body
called antigens, some of the T and B cells become memory cells. Thus,
the next time the individual meets up with that same antigen, the
immune system can be quickly triggered to demolish it. This is the
process known as natural immunity. This truth gave birth to a beLIEf
that if a foreign antigen was injected into an individual, that
individual would then become immune to a future infection. This beLIEf,
(you see the lie in the middle), was given the name, “vaccinations”.
What the promoters of vaccination failed to realize is that secretory
IgA (an antibody found predominately in saliva and secretions of the
gastrointestinal and respiratory tract mucosa) is the initial normal
antibody response to all airborne and ingested pathogens. IgA helps
protect against viral infection, agglutinate bacteria, neutralize
microbial toxins, and decrease attachment of pathogens to mucosal
surfaces. What this author has realized is that bypassing this mucosal
aspect of the immune system by directly injecting organisms into the
body leads to a corruption in the immune system itself whereby IgA is
transmuted into IgE, and/or the B cells are hyperactivated to produce
pathologic amounts of self-attacking antibody as well as suppression of
cytotoxic T cells (as explained shortly). As a result, the pathogenic
viruses or bacteria cannot be eliminated by the immune system and
remain in the body, where they cause chronic disease and thus further
grow and/or mutate as the individual is exposed to ever more antigens
and toxins in the environment. This is especially true with viruses
grouped under the term “stealth adapted”, which are viruses formed when
vaccine viruses combine with viruses from tissues used to culture them,
leading to a lack of some critical antigens normally recognized by the
cellular immune system. One example is stealth adapted (mutated)
cytomegaloviruses which arose from African green monkey (simian) kidney
cells when they were used to culture polio virus for live polio virus
vaccines. Thus, not only was the vaccinee inoculated with polio, but
with the cytomegalovirus as well. The mechanism by which the immune
system is corrupted can best be realized when you understand that the
two poles of the immune system (the cellular and humoral mechanisms)
have a reciprocal relationship in that when the activity of one pole is
increased, the other must decrease. Thus, when one is stimulated, the
other is inhibited. Since vaccines activate the B cells to secrete
antibody,
the cytotoxic (killer) T cells are subsequently suppressed. (In fact,
progressive vaccinia (following vaccination with smallpox) occurs in
the presence of high titers of circulating antibody to the virus[1]
combined with suppressed cytotoxic T cells, leading to spreading of
lesions all over the body). This suppression of the cell mediated
response is thus a key factor in the development of cancer and life
threatening infections. In fact, the “prevention” of a disease via
vaccination is, in reality, an inability to expel organisms due to the
suppression of the cell-mediated response. Thus, rather than preventing
disease, the disease is actually prevented from ever being resolved.
The organisms continue circulating through the body, adapting to the
hostile environment by transforming into other organisms depending on
acidity, toxicity and other changes to the internal terrain of the body
as demonstrated by the works of Professor Antoine Béchamp. He
established this prior to the development of the “germ theory” of
disease by Louis Pasteur. Pasteur’s “germ theory” was a plagiarist’s
attempt to reshape the truth from Béchamp into his own “original”
premise – the beLIEf that germs are out to “attack” us, thereby causing
dis-ease. Thus, treatment of infection with antibiotics as well as
“prevention” of disease with vaccines are both just corrupted attempts
at cutting off the branches of dis-ease, when the root of the cause is
a toxic internal environment combined with nutritional deficiency.
However, since Pasteur’s germ theory was conducive to the profits of
the burgeoning pharmaceutical cartels that only manage dis-ease, no
mention of the work of Professor Béchamp is made in medical school
curricula. To make matters worse than the suppression of cellular
immunity which occurs when vaccines are injected, adjuvants (which are
substances added to vaccines to enhance the antibody response) can
actually lead to serious side effects themselves. Adjuvants include oil
emulsions, mineral compounds (which may contain the toxic metal
aluminum), bacterial products, liposomes (which allow delayed release
of substances), and squalene. The side effects of adjuvants themselves
include hyperactivity of B cells leading to pathologic[2] levels of
antibody production, as well as allergic reaction to the adjuvants
themselves (as demonstrated in Gulf War I soldiers injected with
vaccines containing the adjuvant squalene, to which antibodies were
found in many soldiers). Note that the pathologically elevated
hyperactivity of antibody production caused by adjuvants also results
in a distraction from the other antigens that the immune system
encounters “naturally”, which must be addressed to maintain health. In
addition to the transmutation of IgA into IgE leading to allergic
reactions described shortly, the overall hyperactivity of the humoral
(antibody producing) pole of the immune system is, in this author’s
opinion, the sole cause of all autoimmune diseases. The only thing
which determines which autoimmune disease you develop is which tissues
in your body are attacked by auto-antibodies[3]. If the inside lining
of the gastrointestinal tract (the mucosa) is attacked by
auto-antibodies you develop leaky gut syndrome (which leads to food
allergies when partially digested food particles are released into the
bloodstream, are recognized as antigens foreign to the body, and elicit
an antibody response against those food particles that becomes
heightened every time that same food is eaten and released into the
bloodstream partially digested again). Crohn’s disease and colitis are
also caused by auto-antibody attack on the mucosa of the GI tract
itself. If the islet (insulin producing) cells of the pancreas are
attacked by auto-antibodies, you develop insulin dependent (juvenile)
diabetes. If the respiratory mucosa is attacked by auto-antibodies, you
develop “leaky lung” syndrome where, just as with leaky gut, antigens
recognized as foreign to the body which are inhaled are able to
traverse the lining of the respiratory tract,
causing the creation of antibodies against those antigens (usually
dust, mold, pet or pollen antigens). When these substances are inhaled
again, IgE (the pathologic form of IgA created after corruption of the
immune system due to inoculation rather than inhalation of disease)
acts as a reagin[4] and sensitizes mast and basophil cells, causing
release of their histamine and slow reacting substance granules on
contact with the allergen to produce constriction of the bronchioles
leading to asthma. This process is also responsible for the immediate
hypersensitivity reaction known as anaphylaxis, which is a potential
side effect noted in the Physician’s Desk Reference for every vaccine;
as well as the wheal and flare reaction of the skin known as hives. If
the components of the articular surface of the joints are attacked by
auto-antibodies, you develop rheumatoid (or juvenile) arthritis. If the
skin is compromised on a chronic basis, you develop “leaky skin”
syndrome, where contact antigens which could not otherwise traverse the
skin lead to skin allergies to contact antigens (a delayed
hypersensitivity reaction where inflammation occurs due to release of
soluble factors). Additionally, depending on which level of the skin is
attacked by auto-antibodies, (i.e., the epidermis or dermis), you
develop eczema, psoriasis or scleroderma. If the kidney tissue is
attacked by auto-antibodies, you develop one of the many types of
nephritis, depending on which component of renal tissue is attacked
(for example, with glomerulonephritis, the basement membrane of the
glomerular apparatus within the kidney (which filters blood to form
urine) is attacked by auto-antibodies, thus allowing protein to escape
from the serum into the urine). If you develop auto-antibodies against
thyroid gland tissue, you develop Grave’s disease. If you develop
auto-antibodies against the tissue of the thymus gland (which is
crucial in T cell production and function), you develop myasthenia
gravis. If you develop auto-antibodies against the very DNA in the
nucleus of all cells, you develop systemic Lupus (thus, the autoimmune
potential of DNA vaccines being developed now is self evident; worse
yet, DNA components from these vaccines can be incorporated into your
DNA, leading to actual genetic changes which could cause extinction of
all (vaccinated) life on the Earth, as will be discussed shortly). And
on, and on, and on. The brain and spinal cord can also be attacked with
auto-antibodies (which this author refers to as vaccine induced
encephalitis), leading to a variety of neurological diseases. The most
severe of these, leading to death, are sudden infant death syndrome
(SIDS) and most cases of “shaken baby syndrome”. If components of the
myelin sheath (the insulating covering of nerve fibers which allows
proper nerve conduction) or the actual neurofilaments themselves are
attacked by auto-antibodies, the resultant condition is determined
solely by the location of the damage done. Such neurological conditions
include but are not limited to minimal brain dysfunction, ADD/ADHD,
learning disabilities, mental retardation, criminal behavior, the
spectrum of pervasive developmental disorders (including autism),
multiple sclerosis, Parkinson’s disease, Lou Gehrig’s disease, Guillen
Barre’, seizure disorders, etc., etc. etc. (Please note that other
factors are also sometimes involved, such as: the organism which causes
Lymes disease, aspartame and mercury in cases of MS; aspartame in
seizures; or pesticides in cases of Parkinson’s). Thus, when detoxing
to reverse these diseases, these other substances must also be removed
to obtain a full recovery. However, the corruption of the immune system
caused by the injection of vaccines is a key component in these disease
states leading to immune malfunction, and is the reason why an autistic
child may also have leaky gut or eczema, etc. Note that myelin
production, for the most part, does not begin until after birth. Most
myelin is apparently laid down by age 5 years and usually completed by
age 10
years, judging by the level of success at various ages in reversing
autistic and other neurological VIDS symptoms that this author has
observed in hundreds of children by detoxing the viruses with
homeopathic nosodes[5], and repairing the immune corruption by
simultaneous administration of bovine colostrum (i.e., after 10 years
of age, the ability to stop and repair auto-antibody induced damage in
the myelin sheath and neurofilaments themselves is dramatically
decreased). In summary, the hyperactivity of the humoral arm of the
immune system in autoimmune disease is caused by adjuvants added just
for that purpose. However, the damage caused by the autoimmunity itself
(i.e., antibody against self) has several mechanisms, including the
following:
1. The antigens present in the culture media itself cannot be
completely filtered and separated from the organisms cultured thereon.
Thus, any antibodies formed against antigens from the culture cells
themselves (for example myelin basic protein from chick embryos or the
13 vaccines which now contain aborted human fetal cells) can
cross-react to form an autoimmune reaction against the myelin basic
protein in your myelin sheath, etc. 2. Molecular mimicry is due to
similarity of proteins contained in organisms and mammals. (For
example, the measles virus is made up of proteins similar to myelin
basic protein; thus, antibodies formed against the measles virus
antigens subsequently also cause an auto-antibody attack against myelin
basic protein in the myelin sheath due to cross reactivity of these
antibodies).
3. Formation of immune complexes occur as antigens and antibodies
interlock into clusters which can then become trapped in various
tissues, especially the kidneys, lung, skin, joints, or blood vessels.
Once trapped, these complexes then set off an inflammatory reaction
which lead to further tissue damage. 4. Intentional inclusion of
antigens in vaccines to cause formation of antibodies that attack
specific hormones or races (for example, experiments done on women of
childbearing age in the Philippines and probably other locations where
HCG (human chorionic gonadotropin)[6] placed into vaccines given these
women resulted in antibodies against the HCG hormone, and subsequent
spontaneous abortion thus occurred when the women became pregnant. It
is also this author’s hypothesis that the epidemic of vitiligo in
people of color (hypo pigmentation of skin caused by auto-antibody
attack on melanocytes[7]) is also occurring due to intentional
inclusion of melanin in vaccines given to people of color. Another
heinous (and obviously genocidal) creation of the Anti-Hippocratics is
the DNA vaccines now being developed. These vaccines contain plasmids,
which are closed rings of recombinant DNA that make their way into the
nucleus of a cell and instruct the cell to synthesize encoded antigenic
proteins[8]. Thus, the very genetic makeup of the individual, plant or
animal will be altered to produce a never ending supply of antigens to
distract the immune system. These genetic changes will remain as cell
division occurs, and will be transmissible to offspring. This is the
TRUE “mark of the beast” , and could lead to extinction and/or
modification (including behavioral) of any group inoculated. In
addition to the above phenomena which lead to simultaneous depression
of cellular immune function and hyperactivity of humoral immune
function, vaccines also contain other toxic substances which can cause
serious side effects themselves. The following ingredients are actually
listed on the CDC website with this introductory statement: “Many
things in today’s world, including food and medicines, have chemicals
added to them to prevent the growth of germs and reduce spoilage.”
Translation: you’re already toxic, so what’s the big deal with adding
more poison? This author’s answer to that question is that any
immunotoxin can end up being the “straw that breaks the immune system’s
back” in that individual, leading to dis-ease.
This is where genetics is key; i.e., not that what disease you develop
is actually caused by some “gene” in most cases; but rather that your
genes determine the strength of your immune system (i.e., how many
assaults your immune system can take before it reaches critical mass,
and you develop a dis-ease). Some additional ingredients in vaccines
(as listed by the CDC on their website) include antibiotics, aluminum
gels, formaldehyde, monosodium glutamate (MSG), egg protein, and
sulfites. Thus, we have antibiotics (which you could be allergic to);
aluminum (which when combined with silicon deficiency, results in the
neurofibrillary tangles seen in Alzheimer’s disease); formaldehyde (a
toxic carcinogenic substance used to preserve dead people); MSG ( a
potent excitotoxin[9] which, like aspartame, can cause seizures, brain
tumors, etc.); egg protein (to which you could have a life threatening
anaphylactic reaction); and sulfites (another toxin which we are
advised not to consume much of orally, but in vaccines, it is injected
directly into the body). Is this not a veritable witch’s brew of
chemicals, organisms, and animal parts? What the CDC does NOT list is
that 13 vaccines at present (and more are in the works) are actually
cultured on aborted human fetal tissues (go to www.cogforlife.org for
more info). THIS IS CANNIBALISM. Note in this list that they also fail
to mention the ethyl-mercury containing preservative thimerosol, which
has been the only dangerous substance in vaccines to receive mainstream
media attention (albeit most of that being disinformation) after the
explosion in the rate of occurrence of autism in the last generation
became self-evident proof that vaccines are the causative factor. For,
although the scientists working for the medical mafia continue to use
statistics to twist and spin their data to make us beLIEve that
vaccines are not the cause, too many thousands of parents have watched
their children enter the downward spiral into autism after their
children received the vaccine which was the straw that broke the back
of their child’s immune system. No matter what the “white coats” tell
these parents, they know the truth! Mercury (also in dental amalgam
fillings) is a highly toxic heavy metal, has been documented to cause
cancer, and can be absorbed through the digestive track, skin, and
respiratory track. Mercury is 1,000 times more toxic than lead, and is
second only to uranium as the most toxic metal. If children receive all
recommended vaccines, they will receive many times the “allowable safe
limit” for mercury in the first two years of life (as if there is such
a thing as a “safe” amount of a toxic poison). Yet, even after
Congressional hearings instigated by Congressman Dan Burton (whose own
grandchild became autistic after receiving vaccines) resulted in the
FDA requesting (not ordering) vaccine manufacturers to remove this
toxic heavy metal from their products, mercury is still present in many
vaccines. Although the symptoms of mercury poisoning have been
described as identical to the symptoms of autism, it should be noted
that most children who descend into the hellish state known as autism
do so after the MMR vaccine. The MMR vaccine is one of the few vaccines
that do not contain mercury. Thus, it is self-evident that the removal
of mercury will not make vaccines “safe”. (This is why the mercury is
the only thing being addressed at all; because when the people reading
this paper realize that the very mechanism by which vaccines corrupt
the immune system means that NO vaccine is safe and effective; there
will be an evolution of consciousness where the structure of lies
telling us vaccines are safe and effective disintegrates.) The good
news is that these VIDS can be reversed using natural remedies
(especially homeopathy) contained in the Hippocrates Protocol
(www.drcarley.com). This “surgical strike” detoxification approach
which has the potential to reverse ALL of the aforementioned conditions
under the VIDS umbrella as long as detoxification
is started early enough will be the one truth put on top of the
mountain of lies (that vaccines are safe and effective) that will cause
the entire mountain of vaccine lies to crumble. Thus, the
vaccine-induced holocaust (where instead of people being put in
concentration camps, the concentration camps are being put into the
people) will finally be put to an end. In this author’s opinion, it
will be the reversal of VIDS (especially autism) in children and
reversal of Gulf War Syndrome in the vaccine damaged soldiers and vets
of the American Gulf War Veterans Association (www.agwva.org) led by
Peter Kawaja which will stop this holocaust on humanity caused by
vaccines, since the reversal of dis-ease subsequent to detoxification
of the vaccines makes it self-evident that the vaccines caused the
problem. Unfortunately, we can no longer pretend that this epidemic of
VIDS is merely a “mistake” made by well intentioned, albeit misguided
mad scientists. Because it’s even worse than the above, folks…we are
talking TREASON and CRIMES AGAINST HUMANITY, PETS, and even PLANTS,
(which are also being genetically modified to create vaccines). The
evidence for this is as follows: As concern for population growth
started to grow and the final plans to bring in the New World Order
were put in place, this lie called vaccines was transformed into pure
evil, as it was realized that such delivery systems could be used to
intentionally cause disease, which is now being done under the US Code,
Title 50, Chapter 32, § 1520 and 1524. You can read it for yourself at
your local library. This law has been in place since the 1960's, and it
was last modified in April of 2000. The only stipulation made for
experimentation on human subjects is that local civilian officials be
notified 30 days before the experiment is started. Section 1524 adds
that the Secretary of Defense may enter into agreements with the
Secretary of Health and Human Services to provide support for
vaccination programs through use of excess peacetime biological weapons
(i.e., weapons of mass destruction). In April 2000, § 1520 (a) was
passed to put alleged restrictions on the use of human subjects for
testing of chemical or biological agents after a caller on C Span
mentioned this law in 1999, which revealed this treasonous law to a
huge audience of listeners (including this author, who has been
including it in lectures and written materials since that call came
into “Washington Journal”). However, the exceptions written to Title
50, chapter 32 under § 1520 subsection (b) in the 2000 law passed by
our aiders and abettors of treason in Congress not only loophole back
in a test carried out for "any peaceful purpose that is related to a
medical, therapeutic, pharmaceutical, agricultural, industrial, or
research activity"; but add that such biological and chemical warfare
agents can now be also used for any law enforcement purpose, including
"any purpose related to riot control” (just in case those C Span
listeners should actually get off the couch at the horror of what the
traitors in Washington, D.C. are doing to God’s people). Subsection (c)
of this law now mandates that “informed consent” be required. In
reality, not a single vaccine has ever been tested for its long term
side effects (including carcinogenic potential). Additionally, the
intentional introduction into vaccines of stealth viruses, (including
man-made viruses that cause cancer, mycoplasma and the HIV virus),
antigens which target certain races, and silicon and/or DNA chips in
the future makes it self evident that informed consent is impossible,
as it would initiate impeachment proceedings and war crimes trials
against every “public servant” involved in perpetrating these crimes
against the American people, in violation of the Nuremberg Code (which
was written after the end of WW II to prevent the barbaric experiments
that occurred in the Nazi concentration camps) . What most people don’t
know is that the top level mad scientists from Nazi Germany were
actually brought to the
United States after the war through “Operation Paperclip”, and have
been continuing their work to this day in places like Brookhaven labs,
Cold Spring Harbor and Plum Island in this author’s backyard on Long
Island. In 1969 the U.S. military/CIA and Rockefeller directed National
Academy of Sciences-National Research Council (NAS-NRC) announced that
a research program to explore the feasibility of "creating a new
infective microorganism..[HIV]..which would be refractory to the
immunological and therapeutic processes upon which we depend to
maintain our relative freedom from infectious disease" could be
completed at a total cost of $10 million. Yes, this is what your tax
dollars are going towards, folks. But hang on to your hat, because it
only gets worse. Dr. James R. Shannon, former director of the National
Institute of Health reported in December, 2003 that “the only safe
vaccine is one that is never used”. However, the reverberating truth,
“the shot heard round the world” which will lead to the evolution of
consciousness necessary to stop the holocaust against humanity known as
vaccinations, will be that not only are vaccinations not safe or
effective, but that they are actually weapons of mass destruction being
perpetrated upon humanity in the name of health, for the purpose of
genocide and to bring in the New World Order. Part 2 of the genocidal
plan could drop anytime with activation of the Model State Health
Emergency Powers Act whenever the next fabricated terrorist attack
using biological agents occurs. Worse yet, the Congressional traitors
in Washington posing as public “servants” are doing all they can to
pass “Codex” legislation which will make the natural remedies and
supplements used in the Hippocrates Protocol developed by this author
to reverse all dis-eases only available by prescription. So, you didn’t
hear about that on your local news station either? Please go to the
site of John Hamill of the International Alliance for Health Freedom
(who reversed his schizophrenia symptoms with these natural supplements
and has dedicated his life to stopping Codex from passing) at
www.iahf.com . The most heinous, bone chilling and evil piece of this
puzzle has been revealed to the world by an American hero named Habib
Peter Kawaja, who worked in the late 1980’s as a security and counter
terrorism expert for the United States government (a service for which
he has been rewarded with the murder of his wife, torching of his home,
issuance of a War Powers Act search warrant to (they thought)
confiscate all his evidence, illegal IRS liens on all subsequent
income, and multiple attempts on his own life, all funded by YOUR tax
dollars). Please go to www.agwva.org/mission.htm and read some of the
34 counts that Mr. Kawaja brought against the domestic traitors to
America (in both their individual and governmental capacities) in a
federal lawsuit in which the perpetrators, again, used your tax dollars
to hire themselves attorneys from the Department of “Justice” whose
defense of their war criminal clients was that they are “immune, under
color of law[10]”. (You can listen to Mr. Kawaja on one of his multiple
internet radio shows, including “What’s Ailing America?” which he
co-hosts with this author at www.againstthegrain.info every Monday and
Friday at 11 PM, EST). Wake up, America-it's getting very late….it is
time for the mountain of lies to crumble. Please spread the world to
everyone you know….we will make it happen! The time to stop chopping at
branches and get to the root of this evil is now ! Refer everyone you
know to www.againstthegrain.info, where in the spring of 2005, Habib
Peter Kawaja, as prosecutor for the people, and this author will
commence trials on the internet against the traitors of America for
their crimes against humanity. These traitors include William Atkinson,
MD, MPH of the National Immunization Program at the CDC. On December 9,
2004, Dr. Atkinson informed a NYS Department of Health minion that a
child to whom this author had given a medical exemption
from further inoculation “should be vaccinated unless he has an
anaphylactic allergy to hepatitis B vaccine” as there is “no such
syndrome [as VIDS]”. Yet, in a document published by the CDC on May 4,
2000 (# 99-6194) entitled “Vaccine Information Statements; What You
Need to Know”, on page 9 the following is printed under the heading
“The Law (Recording Patient Information and Reporting Adverse Events):
42 U.S.C. § 300aa-25. Recording and Reporting of Information, (b)
Reporting (2) “A report under paragraph (1) respecting a vaccine shall
include the time periods after the administration of such vaccine
within which vaccine-related illnesses, disabilities, injuries, or
conditions the symptoms and manifestations of such illnesses,
disabilities, injuries, or conditions, or DEATHS occur, and the
manufacturer and lot number of the vaccine.” Thus, while Dr. Atkinson
informed this author on January 8, 2005 that “having a judge in the
Bronx Family Court “qualify” you as an “expert witness” neither makes
you an expert, nor proves the existence of so called “vaccine induced
disease syndrome”; the CDC’s own documents refer to the federal mandate
for such to be reported to the secretary. Dr. Atkinson, who received a
copy of the draft of this paper on 12/30/04, has not offered a single
rebuttal to the mechanism whereby the mechanism of VIDS is explained in
this paper. Ergo, this author hereby formally charges Dr. Atkinson and
his co-conspirators in the CDC with the following counts, including but
not limited to:
01.) False statements within a Government Agency, Title 18 USC §
35.1001.
02.) WAR CRIMES - crimes when death occurs, Title 18 USC § 34.
03.) Concealment, removal - Title 18 USC § 2071.
04.) Aiding and Abetting, Title 18 USC § 3.
05.) Obstruction of Justice, Title 18 USC § 1505 / USC § 2 (26).
06.) Defrauding America, Title 18, USC § 1101 (25). These charges also
surround covert counter-terrorism activities in a lawsuit (go to
www.agwva.org/mission.htm) brought by Peter Kawaja and the
International Security Group, Inc., (1994) as Plaintiffs v. various
[named] Agents (agencies/US attorneys etc) of the U.S. Government and
100 John Does (Bush Administration), and will also be submitted to the
People of the United States and the World in the aforementioned
internet trial to be conducted in the Spring of 2005. The charges laid
in Kawaja's suit have never been refuted by the accused. Instead, the
United States Government made a determination to appoint the US
Attorney's Office to represent the Defendants, thereby admitting to the
criminalities (and guilt). This decision to appoint "government"
attorneys and the U.S. Attorney's Office to represent the Defendants
was made after an initial response to the Plaintiff (Kawaja) filing
Suit, and places these individuals, sworn to uphold the Constitution of
the United States and defend against terrorists (whether foreign or
domestic) into the defendant’s box as well. If the People lead, the
“leaders” will follow…and we have found a true leader in Habib Peter
Kawaja. SILENCE IS CONSENT. If you do nothing, before long highly
trained Special Operations commandos with state of the art weaponry
will be used in the U.S. to “execute quarantine and certain health
laws”, including the Model State Health Emergency Powers Act passed in
all states where, following another domestically perpetrated biological
scare (such as the anthrax mailings to the Congress), a solution in the
form of a vaccine will be offered only to those who will accept the
national ID chip being injected into them. All others will be
considered a danger and threat to society, hunted down, and imprisoned
in concentration camps already built or be killed. Americans will
welcome this solution, and turn in their neighbors or friends in order
to survive themselves. This was all predicted by Peter Kawaja in 1994
when he wrote “The Saddest Chapter of America’s History”. If you are
not part of the solution, therefore, you are part of the problem.
Please do all you can (including telling others about the internet
trial and donating whatever you can at www.agwva.org) to make this
happen. It is now in your hands, People of the United States of
America. Respectfully submitted by Rebecca Carley, MD
www.drcarley.com (The author wishes to thank Mr. Chris Barr, a fellow
radio host on www.highway2health.net and www.againstthegrain.info for
his invaluable additions and editorial assistance in the writing of
this document; and Meryl Dorey of the Australian Vaccination Network,
Inc., whose additions for the publication of this paper in their
magazine “Informed Choice” in Australia have also been included in this
February, 2005 updated edition of this document.)
--------------------------------------------------------------------------------
[1] “IMMUNOLOGY” by Ronald D. Guttman, MD, Professor of Medicine,
McGill University, et. al., (ISBN # 0-89501-009-7), 1983. [2]
Pathologic = pertaining to or caused by disease [3] Auto antibodies =
antibodies produced by the body that attacks its own tissues. [4]
Reagin = antibody of a specialized immunoglobulin class (IgE) which
attaches to tissue cells of the same species from which it is derived,
and which interacts with its antigen to induce the release of histamine
and other vasoactive amines. [5] A nosode is a homeopathically prepared
remedy, made from a disease or a pathological product. Nosodes are used
in the same way as vaccines; they sensitize the body, prompting the
immune system to react (and detox, or eliminate, the offending agent).
However, as they are extremely dilute and oral in application, they do
not lead to the corruption of the immune system caused by inoculation
with disease. [6] Human chorionic gonadotropin = the hormone produced
when women first become pregnant [7] Melanocytes = melanin producing
cells in skin [8] “GENETIC VACCINES”, Scientific American, July 1999,
pgs 50-57 @ p. 52. [9] Excitotoxins are usually amino acids, such as
glutamate and aspartate. These special amino acids cause particular
brain cells to become excessively excited, to the point they will
quickly die. Excitotoxins can also cause a loss of brain synapses and
connecting fibers. Food-borne excitoxins include such additives as MSG
and aspartame, both toxic substances approved for use in humans by the
FDA (Fraudulent Drug Administration). [10] “color of law” = the
appearance or semblance, without the substance, of legal right. Misuse
of power, possessed by virtue of state law and made possible only
because wrongdoer is clothed with authority of state, is action taken
under “color of state law”. Atkins v. Lanning, D.C.Okl., 415 F.Supp.
186, 188. Action taken by private individuals may be “under color of
state law” for purposes of 42 U.S.C.A. § 1983 governing deprivation of
civil rights when significant state involvement attaches to action.
Wagner v. Metropolitan Nashville Airport Authority, C.A.Tenn., 772 F.2d
227, 229. Acts “under color of any law” of a State include not only
acts done by State officials within the bounds or limits of their
lawful authority, but also acts done without and beyond the bounds of
their lawful authority; provided that, in order for unlawful acts of an
official to be done “under color of any law”, the unlawful acts must be
done while such official is purporting or pretending to act in the
performance of his official duties; that is to say, the unlawful acts
must consist in an abuse or misuse of power which is possessed by the
official only because he is an official; and the unlawful acts must be
of such a nature or character, and be committed under such
circumstances, that they would not have occurred but for the fact that
the person committing them was an official then and there exercising
his official powers outside the bounds of lawful authority. 42 U.S.C.A.
§ 1983. (The above definitions are from Black’s law dictionary, 6th
edition, pgs. 265-266) |
| 04/19/2005 |
17:26 |
PU |
463 |
C |
Regarding
cagefory C8, Risk Perception & Protective Behaviors, the impact of
the mentioned social factors on the development, acceptance, and
implementation of preparation and planning activities, that occur
*before* a disaster, should also be assessed. |
| 04/19/2005 |
16:32 |
PU |
459 |
C |
C2:
Rapid clinical diagnosis could also include rapid questionnaire-based
assessments (e.g. for mental health diagnoses), and rapid creation of
new, psychometrically validatable assessment instruments. This ties in
with C10 too, but with a focus on speed of development and deployment
of existing best practice and newly developed instruments
|
| 04/19/2005 |
16:13 |
PU |
457 |
C |
Currently
much of CDC's research is limited to cooperative agreements available
to members of three organizations: Association of American Medical
Colleges (AAMA), Association of Schools of Public Health (ASPH) and the
Association of Teachers of Preventive Medicine (ATPM). There are
respectable and qualified researchers in state and private universities
who do not have a medical school or a school of public health
associated with the university. The CDC reseach agenda should be open
to competition to established researchers who are not members of these
three organizations that are the receipients of umbrella cooperative
agreements. |
| 04/19/2005 |
15:31 |
PU |
452 |
C |
Much of this does not appear to be research. For example, examining the organizational structure ......
This seems more like CDC priorities than research priorities. Or perhaps "things it would be good to know" for our programs. |
| 04/19/2005 |
14:33 |
PU |
448 |
C |
Should
have an objective to do process and outcome evaluations of the funds
which have been distributed to states to prepare for disasters. |
| 04/19/2005 |
13:27 |
PU |
440 |
C |
Research into effective interventions to promote community resilience. |
| 04/19/2005 |
12:03 |
PU |
434 |
C |
Since
much of our preparedness relates well to issues that occur often in our
communities such as disease outbreak and vaccine shortages, some
research should include studies regarding identify the needs and
implementation strategies of families in these situations i.e.
childcare during an emergency, transportation in an urgent situation
and food and water safety. |
| 04/19/2005 |
10:29 |
PU |
425 |
C |
Suggest
inclusion of rural and frontier areas, especially as those touch
international borders, and in particular regard to vector-borne
diseases. |
| 04/19/2005 |
10:23 |
PU |
423 |
C |
I
recommend that the research activities for C.13 also include: Identify
sources, modes, and routes of communication and messages about risk and
protection to prepare the public to responde safely and to cooperate
with authorities in the event of an emergency. [The findings from this
activity will support C.11] |
| 04/19/2005 |
07:45 |
PU |
419 |
C |
There
needs to be coordination between programs (i.e. immunization and
communicable disease) when developing software for BT or disease
outbreak response. |
| 04/18/2005 |
14:02 |
PU |
403 |
C |
Insure mass fatality preparedness and response issues are adequately addressed throughout this area. |
| 04/18/2005 |
13:47 |
PU |
402 |
C |
Many
of the Research themes appear to be overlapping - Community actions,
Local and Regional Operations Strategies, Community and Regional
Response. These might be better merged to reflect their relatedness,
and therefore would be stronger. |
| 04/18/2005 |
13:42 |
PU |
401 |
C |
Suggest
including information about the communication level of the directions,
announcements,.materials to be developed and the modifications needed
for individuals with communication disabilities (e.g.,
cognitive-communication difficulties due to traumatic brain injury,
mental retardation, developmental disabilities, dementia; aphasia and
other receptive or expressive language disabilities) before, during,
and after a disaster. |
| 04/18/2005 |
11:15 |
PU |
389 |
C |
It
is important to understand that disabilities are also important chronic
conditions that affect people's health. Ensuring that we have
surveillance and prevention strategies in place for disabilities should
be a priority. |
| 04/18/2005 |
08:26 |
PU |
381 |
C |
c1
should include a component for the development and implementation of
methods for the detection of infectious diseases in travelers (foreign
and domestic). An example would be the early detection of Legionnaires'
disease outbreaks by centralized real-time analysis of
travel-associated cases of the disease. |
| 04/18/2005 |
07:29 |
PU |
377 |
C |
Several
bulleted C3 "Environmental Detection and Decontamination" items under
the Starter list including 1) • Quantify risks associated with mold
exposure in the home work environments; 2) Outline risks associated
with exposure to chemicals; and 3) Describe risk associated with injury
events, should instead be under C4 "Risk Assessment and Management
Strategy. "Health and Injury" should be added to the C4 titled.
For the research on better tracking and surveillance for early
detection, the systems should be phased, prioritized, and separated
sufficiently to cover the broad areas of response and preparedness
activities to safeguarding human life including:
a) possible threats from space, 2) human-induced global changes, 3)
international conflicts and war, 4) utility disruptions and
blackouts/brownouts, 5) geological and meteorological events (volcanoe
eruptions, earthquakes, mudslides, flooding, shore erosion from storms,
tornadoes, hurricances/typoons, lightning), 6) naturally occurring
disease outbreaks, 7) terrorism and intentionally caused disease
outbreaks and disasters, 8) unintentional health outcomes from daily
lifestyle choices (where work, where live, what drink, what eat, how
travel, etc.). 9) spills and unintentional releases of hazardous and
toxic substances (waste sites, pipe and container spills, production
facilities and emissions, etc.), and 10) recreational activities
(where, what, exposures to environmental media, etc.) |
| 04/18/2005 |
07:27 |
PU |
376 |
C |
Bullying
in school and other kinds of school or community exposure to emotional
abuse and violence should be a prominent component of this agenda. |
| 04/15/2005 |
15:30 |
PU |
365 |
C |
Will
there be any items on state/local agency collaboration with local
communities, and private organizations in dealing with preparedness. |
| 04/15/2005 |
14:13 |
PU |
361 |
C |
The
greatest contribution CDC could make to the safety and health of the
public is to begin a dialogue on the delivery of health care in our
communities in a non-partisan, non-ideological, open discussion.
Promote objective reviews and educational forums to educate the public
on both the short-comings and the advantages of our current approach to
health care delivery. Leave no stones unturned. Review the AMA, the
health insurance companies, our legal system, the educational system,
and federal funding. Present alternative approaches that other
countries have employed to avoid our deficiencies and report
objectively their failures and successes. If the American public had
the objective information they need to evaluate our health care system,
we would not have the system we now have and millions of lives would be
saved annually. This is an annual loss greater than any plaque or war
our country has endured. This could be the number one accomplishment of
CDC in this century. |
| 04/15/2005 |
13:24 |
PU |
359 |
C |
C1,
I think CDC has explored quite a few non-tranditional systems, and they
often approved to be not effective. The resources should be spent on
how to make tranditional systems work better instead of developing some
fancy, good for IT only, nontranditional systems.
|
| 04/15/2005 |
09:54 |
PU |
352 |
C |
Need to educate the public and encourage then to do the things necessay to have all things in place |
| 04/15/2005 |
09:54 |
PU |
351 |
C |
Need to educate the public and encourage then to do the things necessay to have all things in place |
| 04/15/2005 |
09:06 |
PU |
348 |
C |
True
preparedness requires a strong public health infrastructure. Research
is needed to define what structure provides the greatest positive
impact on population health. |
| 04/15/2005 |
08:00 |
PU |
347 |
C |
I
would rather see this labeled community health and prevention. None of
the other topics appear to address the basic issue of the local
community or considers the local culture, economy, geography,
education, and general health and belief systems. The whole issue of
terrorism preparedness has become a political boondoggle, wasting
millions of taxpayer dollars. My comments do not necessarily reflect
the opinions of my department or school. |
| 04/14/2005 |
15:48 |
PU |
339 |
C |
Important - but so many other agencies are addressing this. |
| 04/14/2005 |
14:18 |
PU |
337 |
C |
Although
this is an important area for CDC's participation, it is not uniquely
CDC's niche and I don't think it should be listed number #1. |
| 04/14/2005 |
13:26 |
PU |
332 |
C |
Behavioral science seems to get short shrift on this list. |
| 04/14/2005 |
13:22 |
PU |
331 |
C |
Like strategies for assesssing readiness of state systems for response activities. |
| 04/14/2005 |
13:13 |
PU |
330 |
C |
I
think terrorism is not a serious public health priority. There are far
more people ill, injured and dead from dozens of other threats. |
| 04/14/2005 |
12:14 |
PU |
324 |
C |
for example, where on the list does this suggestions appear?
test only |
| 04/14/2005 |
12:13 |
PU |
322 |
C |
While
this is an important area, I don't recommend it be placed at number
one. I think that most of our current health problems are directly
related to the lack of more intensive long term intervention studies to
identify program strategies for sustaining health behaviors. |
| 04/14/2005 |
12:07 |
PU |
321 |
C |
I
suggest we do a study of whether there is an spike in injuries or other
adverse effects right after the time changes to or from daylight
savings time. |
| 04/14/2005 |
11:54 |
PU |
320 |
C |
Develop
a Central Resource person as the POC for Responders in need of
psychological de-briefing and follow-up, and for families of Responders
in cases of adverse outcomes. |
| 04/14/2005 |
11:49 |
PU |
319 |
C |
Develop effective psycho-social screening tools to screen responder applicants beyond just their academic credentials. |
| 04/14/2005 |
11:33 |
PU |
316 |
C |
C1
- I don't see a research component here. This is a program activity but
I don't see what the research questions are related to this activity.
There are other examples in this section that appear more program
oriented than research oriented. |
| 04/14/2005 |
11:05 |
PU |
315 |
C |
Include
research on susceptibility to disease and pathogens (natural and
terrorist released) to help decide who to treat first. Also consider
research on metabolism of antibiotics or other preventive measures that
might be given to improve effectiveness. |
| 04/14/2005 |
10:31 |
PU |
308 |
C |
The
research agenda assumes certain levels of readiness are in place. Are
they? There are more fundamental research questions that need to be
addressed to insure that we are abel to detect and respond to an even
in a timely way?:
What are the predictors of a rapid response?
What determines which outbreaks of unknown origin get full rapid
response attention at the local level?
What are the average response times for outbreak response for critical
agents, possible chemical attacks, and what are the determinants of
those times?
Who reports outbreaks and why?
What are the incentives/disincentives for reporting? What can we do to
increase reporting and early reporting?
What is "community" public health? or Who are we to communicate with in
the absence of county or city health departments in preparedness and
assessing preparedness of public health?
|
| 04/14/2005 |
10:18 |
PU |
305 |
C |
CDC
is fortunate to have workers who are fluent in Non-English languages.
In the event of an emergency it will be improtant to know who can
assist with understanding, reading, writing, and developing emergency
messages in other languages. How can we create a rapidly accessable
database of volunteers listing their comfort level with other languages
and cultures. |
| 04/14/2005 |
10:10 |
PU |
303 |
C |
I am getting a 'file error' when i 'click here for Starter list' on all of these items 1 through 7. |
| 04/13/2005 |
16:22 |
PU |
289 |
C |
C2
- Expand Rapid Clinical Diagnostic Capabilities through research
activties targeting development of rapid tests capable of detecting
very early exposures and that are robust -capable of holding up under
very broad and varied testing environments with minimal skills required
for perfoming the test ( CLIA waived) |
| 04/13/2005 |
15:18 |
PU |
282 |
C |
C8
include people with various disabilities (mobility, hearing, vision,
cognitive, communication) among vulnerable populations
example of research - assess the extent to which federal, state, and
local emergency preparedness plans and response history has included
people with disabilities
C10 - include effectiveness of risk communications for people with
various disabilities
example - what are effective communication strategies for communicating
risk to people with cognitive impairments? |
| 04/13/2005 |
11:57 |
PU |
275 |
C |
To
my knowledge, neither CDC nor CMS has a comprehensive and current
database of nationwide medical laboratory testing services, which
includes all human testing laboratories--clinical and anatomic--with
all tests offered. Such a comprehensive resource database, if updated
annually, would benefit bioterror preparedness efforts, public health
resource management, screening test capacity (toxicology and cancer
screening), and laboratory workforce assessment; it would benefit CMS
in their CLIA regulatory work. |
| 04/13/2005 |
09:55 |
PU |
270 |
C |
Currently,
there is infrastructure in place to track the distribution of childhood
vaccines through the Vaccines for Children (VFC) network but there is
no similar infrastructure or informational network for adults. A
Vaccines for Adults (VFA) program that incorporated influenza and
pneumococcal vaccines would provide the basic infrastructure needed to
distribute vaccines in the case of a pandemic and would make vaccines
available to undervaccinated segments of the adult population. Some of
this infrastructure was activated during the recent flu vaccine
shortages. In addition, it would be possible to incorporate community
organizations such as Fire Departments to administer vaccines to
adults. With a VFA, manufacturers would keep distribution records in
the same manner that they keep VFC records currently. This information
and infrastructure would be invaluable in the face of a pandemic, or
terrorist act. |
| 04/12/2005 |
14:51 |
PU |
264 |
C |
•
Community Preparedness and Response: the 18 themes for this initiative
cover quite well the types of research needed to address bioterrorism
and other public health threats. The AADR suggests that, within
research activities such as integrating traditional and nontraditional
data systems to improve threat identification, assessing optimal roles
for practitioners, preparing key personnel and identifying shortages in
the workforce, the CDC consider the use of the dental office team.
Suggestions in this regard have been made by the ADA and by a consensus
workshop held in 2003 and sponsored by CDC, NIH, AADR, ADA, ADEA,ASTDD,
et al. Dental offices are distributed across the community and can
serve as an excellent surveillance resource, by observing and reporting
characteristic lesions and /or unexplained patterns of employee
absences or patients’ missed appointments. Dental offices may be also
used as “mini-hospitals” if local hospitals are overwhelmed or when it
is desirable to avoid concentrating patients in a single location.
Dentists may also be used to provide treatment for cranial and facial
injuries, take medical histories, administer CPR, and perform a host of
other medical augmentation procedures. Saliva-based diagnostics are
available or under development that are capable of rapidly identifying
anthrax, lead, and other toxins.
|
| 04/12/2005 |
10:30 |
PU |
261 |
C |
Embeded
and highlighted within this research topic there has to be a focus on
community based participatory research (CBPR) and partnership with
grassroots organizations. |
| 04/11/2005 |
09:59 |
OH |
251 |
C |
see general discussion comment below |
| 04/08/2005 |
13:56 |
PU |
233 |
C |
Please indicate how we can submit our comments now available in Word file of the Stater list, relying on track changes.
Thanks,
Kenneth G. Castro, M.D.
kcastro@cdc.gov |
| 04/07/2005 |
19:03 |
PU |
227 |
C |
As
long as all disasters are included this is certainly a valid field. I
think that research should be directed to evaluating levels of
preparedness, and strengthening the public health infrastructure to
deal with disaster preparedness. If public health surveillace was
sufficient, it would be possible to identify public health disiasters
in real time. |
| 04/07/2005 |
15:59 |
PU |
224 |
C |
C.8
- Include the assessment of service utilization by discrete
populations.
C.11 - Identify the appropriate mechanisms for the diffusion of
messages in various communities specific to the appropriate health
disparities |
| 04/07/2005 |
10:09 |
PU |
209 |
C |
Consider
adding research related to the increasing use of contractors in the
federal public health workforce and the impact on emergency response
capabilitites. Contractors are not allowed to be trained as back up to
the FTE's who are the initial responders; what impact does this have on
emergency preparedness? |
| 04/07/2005 |
09:19 |
PU |
201 |
C |
We
should asess our communities impact on others and perception by others
which may lead to hostilities. This would be much more effective than
providing protection from myriad of possible and devastating fronts. We
should also assess danger brought to the public due to military
interventions. |
| 04/07/2005 |
07:53 |
PU |
192 |
C |
C-2
& C-7 -- don't these fall more under NIH's pervue? In general, this
topic seems to reflect CDC's new interest, but since chronic diseases
kill 70% of Americans (and an increasing number world-wide), it seems
to me to be more appropriate to put it further down the list. |
| 04/07/2005 |
06:45 |
PU |
190 |
C |
This
is important, but money spent on personnel or equipment for some
specific individual radionuclide analytical methods that are highly
unlikely for radiological terrorist implementation would not be cost
efficient. Alpha counting banks, for example, are very sample
preparation intensive and typically very low throughput. These should
be scrutinized for justification. First responder and local health
provider response preparedness would be cost efficient. |
| 04/06/2005 |
08:33 |
PU |
177 |
C |
The draft list of priorities is comprehensive, thoughtful and timely. I
can not think of additional, crucial, areas of concentration, but
suggest the following two areas of emphasis: physical injuries and
mental health consequences of disasters and terrorist incidents. While
the US has undertaken massive (and appropriate) investments in
preparedness activities to address possible chemical, biological and
radiological disasters, the fact remains that the vast majority of
terrorist-related morbidity and mortality to date has been traumatic in
nature.
A key question is how terrorist-related injuries differ from domestic
injury patterns and what preparations are necessary to respond to these
differences? To answer this question, in addition to the descriptive
epidemiology, additional comparative analytic studies are necessary.
Variables that are associated with severe injury and fatality must be
identified. These variables should be amenable to rapid ascertainment
by responding personnel. They should contribute in a meaningful manner
to a model for prediction of survival in trauma patients. Additional
questions include: What are the types, prevalence and incidence of
fatal and non-fatal injuries? What are the demographic characteristics,
including race, ethnicity and socio-economic status, of the affected?
How are victims transported. What were the treatments? What were the
outcomes? This kind of information is crucial for medical and public
health professionals and community planners and policy makers to
prepare for the possibility of terrorist incidents and disasters.
Second, recognizing that the aim of terrorism is to terrorize,
epidemiologic data on the behavioral consequences of disasters is
essential to help guide relief and recovery efforts. Such information
has implications for medical and public health response to surge
capacity needs. It has been noted that the effort “required to collect
the information necessary to provide apt and well-directed aid is more
than justified by the improved results” . Yet, there are no uniform
definitions among the multiple sources of health information , and
collecting data is difficult. Data on mental health care needs and
service requirements after disasters even more difficult to define and
obtain.
Thanks for this opportunity to comment.
C. DiMaggio
|
| 04/05/2005 |
23:13 |
PU |
175 |
C |
this is important when the focus includes infectious diseases such as TB |
| 04/05/2005 |
19:50 |
PU |
174 |
C |
There
needs to be a focus on the role of Trauma Centers in disaster
preparedness. Although not to minimize bioterrorism, most disasters
include physical injuries. Not every hospital is adequately prepared to
handle these injuries |
| 04/05/2005 |
18:11 |
PU |
172 |
C |
Please
include research and support for the nation's TRAUMA SYSTEMS and TRAUMA
CENTERS. The EMS and Hospital systems that daily support the emergency
health care needs of the nation have a great many system,
communication, preparedness, and response needs which are not being
addressed. These systems are not currently organized for wide-spread
disaster response. Thank you. Raelene Jarvis, RN |
| 04/05/2005 |
15:12 |
PU |
171 |
C |
recommend you strongly consider including TRAUMA CENTERS in your funding for disaster prepardness/terrorism activities.
|
| 04/05/2005 |
14:32 |
PU |
167 |
C |
Support of Trauma Centers would be appropriate. |
| 04/05/2005 |
14:21 |
PU |
166 |
C |
Please
consider including TRAUMA CENTERS and emergency departments as they
provide a vital function in the event of a disaster or terrorism event.
|
| 04/05/2005 |
13:36 |
PU |
163 |
C |
Please
consider supporting Trauma Centers in funding for Disasters. Trauma
Centers are having difficulty staying afloat financially. Should a
disaster of any magnitude strike anywhere, the public will be heading
to the closest trauma center whether they need to be there or not.
Trauma Centers are faced with budget cuts annually. Help for the
centers is needed. I am not talking about disaster equipment - hazmat
tents and the like, but actual financial support just to stay in
business. Monies should be set aside from taxes placed on cigarettes,
alcohol. and the sales of large SUVs - these are at the root of many
traumatic incidents occuring daily that is largely ignored by the
government. A portion of the taxes placed on the above items should go
directly to the states to be distributed to each verified trauma center
within the state. A simple idea that could make a world of difference
in readiness!
Thank you |
| 04/05/2005 |
13:15 |
PU |
162 |
C |
Trauma
Centers need to be include in funding grants for prevention and
preparedness to respond to all kinds of events both natural and man
made from disease outbreaks to terrorism. Trauma centers are the lead
organizations in communites that have the organized structures in place
that need enhancement we should not be duplicating process for just one
type of event it should be seamless not matter what type of event and
we should build on each strenght. I would encourage funding for trauma
centers. |
| 04/05/2005 |
13:14 |
PU |
161 |
C |
Include
Trauma Centers in your funding priorties. They will be responding to
all terrorist and environmental challenges and the resources for Trauma
Centers currently is overtaxed in the Unitied States and needs support. |
| 04/05/2005 |
12:38 |
PU |
160 |
C |
This
money should be spent on trauma related issues and not bioterrorism.
There has been a lot of money spent thus far on bioterrorism yet most
terrorist activities and disaster situations are trauma related (ie
bombs etc). Additionally, I ask you to strongly consider targeting
trauma centers as they are the leaders in the community in trauma and
have also been exlcuded in prior funding. |
| 04/04/2005 |
13:30 |
PU |
156 |
C |
While
the topics are important. Aren't there enough federal agencies already
involved (e.g., FEMA, etc.). Adding this to the NCIPC agenda depletes
funds and attention to other relevant topics/problems. |
| 04/04/2005 |
11:51 |
PU |
153 |
C |
Please
consider addressing pediatric populations, particularly in the critical
settings of schools, communities, and medical centers. In the threat of
a disaster, pediatric populations are often lost in the shuffle and not
considered in preparedness efforts. However, in an actual disaster,
pediatric populations are often the most drastically impacted.
Pediatric populatins also tax our preparedness efforts - think for
example of mothers with their children flooding the Emergency
Departments following threats of air-borne pathogens and overwhelming
the medical system. Schools are often targeted as sites of relief in a
disaster (such as being a Red Cross site or a place to dispense food
and water), but are rarely included in preparedness efforts focusing on
how to best help children. Crisis plans in pediatric settings can also
be iatrogenic for children - such as complete lockdowns in school
crisis situations, which worsens the impact for children who then
experience prolonged parental separation. With all community
preparedness and response research, I hope the CDC can be a leader and
consider pediatric populations not as an afterthought but as a primary
focus. |
| 04/04/2005 |
11:34 |
PU |
151 |
C |
Less time and money should go into this focus area. |
| 04/04/2005 |
11:05 |
PU |
147 |
C |
Please
focus less on terrorism than natural disasters (in places that have
them regularly) and natural disease outbreaks. Foucusing research
dollars on terrorism seems to just add to the hype. |
| 04/03/2005 |
21:43 |
PU |
144 |
C |
while
it is very important for CDC to plan, develop and evaluate responses to
ever emerging and unknown threats, i hope CDC will also look at threats
that are much more likely to occur and are occuring daily all across
the USA and that is the meth lab, the chemicals used in them and the
high proobability of explosions... it is a human made disaster that is
quickly reaching epidemic proportions. |
| 04/01/2005 |
08:20 |
DC |
142 |
C |
Review
smallpox preparedness guidelines. Do hospitals need to be able to
vaccinate all their staff and families in a 24 hour period? The CDC
response to TV shows indicates that people will not get infected unless
there is prolonged exposure. The messages appear to be in conflict. Is
it time to mandate influenza vaccine for all health care workers? |
| 03/30/2005 |
10:37 |
DC |
131 |
C |
Would
appreciate mre information on what rural communities need to focus on
for preparedness. With limited resources, personnel and access to
supplies, how can a small community become well prepared. |
| 03/29/2005 |
15:48 |
DC |
119 |
C |
Most
leaders in tha area of emergency preparedness are not willing to focus
much effort in the area of disease outbreaks. There seems to be a
feeling or thought that there isn't much we can do to save lives in
this area. Healthcare is very much more prepared for a mass casualty or
CBERN event. |
| 03/29/2005 |
10:57 |
DC |
114 |
C |
It
appears that the area wide preparation for natural disasters as well as
chemical type exposures has been well addressed. The concern I have is
that I feel we are poorly prepared for bioterrorism and pandemics. It
appears in our area that all the federal funds have gone to fire
department and other first responders and has been used to prepare for
chemical incidents. Infection control was not even invited to
participate within the committee that worked on this issue. When
infection control expressed our concerns the response appeared to be
that by the time we identify a bioterrorism incident there will be so
many exposures that we will not be able to cope. I am employed in a 134
bed facility and we do not have the ability to shut off air handlers
and close off areas of the facility. If it is pandemic influenza, we
would probably be overwhelmed and full but could provide safe quality
care to the patients. If we are hit with bioterrorism, I feel that we
will not be able to respond safely. I do not know what the answer is as
this is a very difficult situation, however, I think it is important to
express the concerns regarding how we would handle this type of
situation. If it is a terrorist attack that would require special air
handling issues, we would be in serious trouble. This could even be
said for such diseases as SARS. |
| 03/29/2005 |
10:57 |
DC |
111 |
C |
I
believe it is critically important not to let fear mongers divert
dollars to terrorism when disease outbreaks and natural disasters are
known problems that affect many people. The infrastructure required to
deal with those things will assist in the unlikely event of a terrorist
attack, but the planning should be done with common things in mind
first. |
| 03/28/2005 |
13:29 |
DC |
102 |
C |
Community
Preparedness remains a priority issue for many of us in healthcare. We
recommend further research on transmission risk related to specific
diseases to support prudent use of limited resources. Disease specific
references will continue to be needed to guide planning in our city. |
| 03/28/2005 |
12:43 |
DC |
92 |
C |
having the ability to quantify syndromes in clinical areas |
| 03/28/2005 |
12:40 |
DC |
90 |
C |
More
funding needed for training, to increase ICU capacity, create more
negative pressure rooms and to stockpile supplies. Few hosptals have
more than 48hrs of supplies on hand at any one time.
Cities need a plan to hold and triage mass casualties in non-hospital
venues to keep hospital access clear or hold patients for quarrantine. |
| 03/28/2005 |
11:48 |
DC |
82 |
C |
Methods
(including disaster drills) to examine how well a community is prepared
to respond need to be examined. Disaster drills should be required of
communities to be performed on a regular basis. The variety of
disciplines among community-based public health workers and
hospital-based healthcare workers are not used to networking or working
together. Any disaster preparedness exercises performed as well as real
disaster situations should be evaluated using a standard set of
criteria in much the same way investigations are performed by the FAA
for airplane accidents. |
| 03/28/2005 |
11:33 |
DC |
78 |
C |
Hospitals
should be prepared to have single use space for infectious patients.
Alcohol handwash should be readily available in hallways for care
givers.
Provide community wide opportunities for hand sanitizers in areas where
people congregate such as in movie theaters, grocery stores, a major
sporting events. |
| 03/28/2005 |
11:05 |
DC |
75 |
C |
I
would like to see a database with medical as well as patient
educational material that healthcare entities can download and adopt.
This would lead to standardized healthcare educational information
being handed out to patients. This would also lead to nurses and other
key caregivers being educated to the same information which as been
researched by CDC, rather than to individualized interpretation. |
| 03/28/2005 |
10:14 |
DC |
69 |
C |
Need
to make the flu vaccine mandatory for health care providers. This will
be the biggest tool to help prevent a pandemic. Need more vendors for
the vaccine. |
| 03/27/2005 |
16:24 |
DC |
55 |
C |
The
annual Flu and Flu-like illness are infact a model for a bioterrorist
attack. There is much the CDC could do today to improve the
coordination and dissemination of the data. I would be happy to supply
CDC with some recommendations Will Sawyer MD 513-769-4951 or
dr.will@henrythehand.com |
| 03/25/2005 |
13:08 |
DC |
51 |
C |
CDC
needs to take the lead in better vaccine development--not just leaving
it to the drug companies who are only out to make money. |
| 03/25/2005 |
11:30 |
DC |
49 |
C |
I
have been fortunate to be asked to attend regional emergency
prepardness meets with county EMS, Hospitals, etc. Though everyone is
attempting to train to the best of their ability, there is not enough
structure. Funding is being given to help with training and preparation
but unfortunately most of this will be wasted as there is a lack of
understanding and control of all the involved entities. I recently sat
in on one of these meeting where a gentleman from an EMS talked 45
minutes as to why he didn't have time to activate the FRED system to
notify hospitals and other entities of emergencies. A debate ensured as
to whom would notify the hospitals. This should not be up for
discussion. There should be specific direction from the federal level
as to how this is to work. I realize that the CDC is not responsible
for this aspect of emergency response terrorism however, if no one
knows that an emergency occurred or how to deal with the emergency, the
rest will not matter. |
| 03/15/2005 |
00:18 |
WA |
25 |
C |
Research
needs to be done on areas of vaccine distribution and also control of
infectious diseases as a global problem such as the possibility of bird
flu passing from human to human and into the US through our airports,
etc. |
| 03/13/2005 |
17:18 |
OH |
21 |
C |
Mollie,
this is a test to see if I can submit comments anonymously without
registering. I want to tell Public Meeting participants to submit extra
comments at this website after the meeting if they like. Please confirm
you got this message. Thanks. Robin |
| 03/11/2005 |
07:02 |
GA |
18 |
C |
Transparency of resource allocation with goals |
| 03/04/2005 |
08:23 |
DC |
10 |
C |
1.
Develop research agenda around emergency preparedness for people with
disabilities. Looking to learn more about best practices, program
evaluation and outcomes. |
Back
to Top
|
| Date |
Time |
Type |
ID |
Group |
Comment
|
| 04/19/2005 |
18:17 |
DC |
466 |
E |
1.
Prioritize research on the relative role and effectiveness of
respiratory protection and need for fit-testing in the control of
transmission of various infectious agents, including Mycobacterium
tuberculosis.
2. Outcome research (transmission studies) to define the relative
importance of the hierarchy of controls in preventing healthcare
associated transmission of Mycobacterium tuberculosis and other
infectious agents potentially transmitted via the airborne route:
administrative, environmental and personal protective equipment.
3. Health outcome and cost-benefit studies on the use of personal
protective equipment: types of respiratory protection, frequency and
utility of fit-testing.
4. The relative role of patient characteristics, procedure-related
events and environmental sources of infectious agents in airborne
disease transmission
|
| 04/19/2005 |
17:26 |
PU |
463 |
E |
There
needs to also be research addressing the impact of government and
corporate policies and activities on the various areas addressed here,
such as the built environment, the organization of work, environmental
risk factors, etc. |
| 04/19/2005 |
16:59 |
PU |
462 |
E |
As
a NIOSH epidemiologist and Co-chair of NIOSH's National Occupational
Research Agenda's (NORA) Reproductive team, I'm stunned and discouraged
to see this list. Perhaps eight of the 21 NORA areas which were
considered important by NIOSH over the last ten years are considered.
And injury is considered, and considered, and considered! Injury is
important, and it's a lot easier for PART purposes to demonstrate
impact with fewer injuries, but there are entire occupational areas
which have conversely been left behind. There is no mention of chronic
conditions including reproductive health. Granted, aspects of
reproductive health are covered in health promotion research, but
nowhere in that document is any reference made to occupational
exposures. These exposures will impact not only the affected workers,
but in many cases, their children. As many as 55% of children are born
to working mothers, and 65% of working men and women are of
reproductive age. Most workers spend roughly a third of their lives at
work.
There is a good deal of cynicism among many here that any comments
forwarded regarding occupational health will be filed in the "circular
file". Can you truly afford to do this when ignoring occupational
exposures may distort research findings?
[comment from Barb Grajewski, NIOSH] |
| 04/19/2005 |
16:57 |
PU |
461 |
E |
Theme
ID# E11-E12: I think it would be very helpful to list specific examples
of priority risk and protective factors for adolescent injury
prevention that would be the focus of future research. For example,
current and binge drinking among adolescents is a key risk behavior for
unintentional injuries and violence among youth. However, further
research is needed to assess the impact of specific intervention
strategies (e.g., reducing alcohol marketing to youth) on alcohol
consumption and injury outcomes in this population. It would also be
very helpful to conduct translation research aimed at assessing
effective approaches to helping communities implement effective
strategies to prevent youth drinking. In addition, it would be helpful
to assess the impact of home policies restricting youth access to
alcohol.
Theme ID# E13: I would specifically highlight research on how to
implement screening and brief intervention for alcohol problems in
trauma centers as an important example of Trauma Systems Research. |
| 04/19/2005 |
16:57 |
PU |
460 |
E |
reproductive
hazards in the workplace for both men and women
like lead, eliminate asbestos exposure both in workplace and built
environment
mixed exposures, rather than just chemical mixtures. For example,
effect of joint or successive exposure to chemicals and radiation,
viruses and fibers, etc.
Methods developmnent for workplace exposure assessment -- should we be
concerned with particle size; mixed exposures; intensity, cumulative,
or timing of exposure; fiber size, dimensions, or biopersistence; etc.
Develop an overall workplace disease screening/intervention
strategy--i.e., develop disease screening protocols for specific
agents, guidelines for evaluation of group data, and identify cutpoints
that define when workplace intervention is needed to reduce exposure. |
| 04/19/2005 |
16:13 |
PU |
457 |
E |
Currently
much of CDC's research is limited to cooperative agreements available
to members of three organizations: Association of American Medical
Colleges (AAMA), Association of Schools of Public Health (ASPH) and the
Association of Teachers of Preventive Medicine (ATPM). There are
respectable and qualified researchers in state and private universities
who do not have a medical school or a school of public health
associated with the university. The CDC reseach agenda should be open
to competition to established researchers who are not members of these
three organizations that are the receipients of umbrella cooperative
agreements. |
| 04/19/2005 |
15:31 |
PU |
452 |
E |
Why
is injury prevention research included here and in the Health Promotion
Research area? They both deal with prevention. Is the research for
environmental and occupational health also prevention research? |
| 04/19/2005 |
14:33 |
PU |
448 |
E |
E15
is very important area of research, and should include work on the
biological effects of violence on a developing child (e.g., neural
pathway development).
E16, occupational injuries, should include as one major category,
exposure to secondhand smoke to settle once and for all in the minds of
those would have has us believe that there is any uncertainty the
negative health effects (especially in hospitality, restaurant and bar
workers) of short-term and long-term secondhand smoke exposure at work. |
| 04/19/2005 |
14:20 |
PU |
446 |
E |
E5
– Examples for studying the impact of design on communities should
include liquor store density in relation to crime rates and types of
crimes (violent vs property).
E8 – Examine the reduction of injuries and violence by examining
measures to reduce environmental alcohol exposure through zoning laws
for liquor store density, banning alcohol at community events, etc.
E9 – Research into lowering legal blood alcohol limit in relation to
motor-vehicle crashes – use studies from other countries showing the
effect of lower limits
E10 – In addition to ethnic and racial disparities in violence, also
consider the differences in risk behaviors among these groups
especially with regards to binge drinking and heavy alcohol
consumption.
E11 – Risk factors such as binge drinking must be included to develop
interventions for unintentional adolescent injuries. Evaluation of
current laws and the enforcement of underage drinking laws should be
included in this arena.
E12-E16 Studying the impact of binge drinking and heavy alcohol use in
relation to prevention of injuries in these age groups and categories
is important and can better help focus interventions.
|
| 04/19/2005 |
13:27 |
PU |
440 |
E |
Research into ways to promote positive human interpersonal interactions through appropriate environmental design. |
| 04/19/2005 |
12:36 |
PU |
438 |
E |
1)
Emerging contaminants such as endocrine disruptors, aquatic toxins,
pharmaceuticals should at least be mentioned in the research agenda
2) Starter list is very long and detailed on the injury and violence
side, but very short and general on the environmental health side. I
would like to see some topics that relate to the practice of
environmental health, such as onsite sewage treatment and drinking
water quality |
| 04/19/2005 |
10:59 |
PU |
428 |
E |
some priority given to high risk, vunerable populations (children, young girls, pregnant women and the elderly) |
| 04/19/2005 |
10:29 |
PU |
425 |
E |
Suggest
inclusion of farm safety issues, particularly in regard to exposure of
children and non-English speaking workers to insecticides, herbicides,
and fungicides. Suggest effort to make available in Spanish (and in
visual graphics) MSDS (Material Safety and Data Sheet) information. |
| 04/19/2005 |
10:23 |
PU |
423 |
E |
Themes
E.8 and E.9 are essential to prevention and translated research
findings into public health practice.
I recommend that the research activities for E.10 also include:
Investigate how injury-related health disparities cross-cut
disease-related health disparities (e.g., interpersonal violence as
barrier to condom use) to develop interventions that can be integrated
into other CDC prevention programs. |
| 04/19/2005 |
02:23 |
PU |
416 |
E |
An
additional activity to list for E3--
Use the occurrence of disease (eg, cancer) clusters as an opportunity
to recruit willing cases for inclusion in etiologic studies.
On a related theme, I would ask that CDC partner with NCI and the state
cancer registries to develop a complementary strategy for advancing
understanding of the etiology of childhood leukemia. |
| 04/18/2005 |
15:33 |
PU |
410 |
E |
Violence
prevention seems to take a back seat to imjury. Violence has widespread
effects on the health of the community. It also has implication for
community preparedness- as in school killings, terrorism from our own
citizens, people who are willing to die as they kill others. Please
keep violence prevention alive. |
| 04/18/2005 |
13:47 |
PU |
402 |
E |
These
research priorities appear to be individual projects, with little
cohesiveness and a limited common foundation. Some way to categorize
risk areas - work, travel, home, etc. might make this more logical. |
| 04/18/2005 |
11:15 |
PU |
389 |
E |
Given
that approximately 17% of children have a developmental disability, it
should be seen as a very important priority to determine the causes of
disabilities and to invest in the early identificaiton and prevention,
whenever possible. It is also important that we understand more about
cumulative and combined environmental exposures in relation to genetic
and biological predispositions of individuals. Looking for the single
exposure that directly causes a disease or disorder is too simplistic. |
| 04/18/2005 |
10:12 |
PU |
387 |
E |
I
think research need to be performed on how the environment and the food
we eat affects children. There has been a surge in unknown development
delays and respiratory issues among our young children within the past
10 years and no one seem to be concerned. I understand their is a
higher agenda to make money, therefore the problem is patched up with
medicines that really only benefit the drug companies. Are the children
really our future? If so. Why don't we get to the root of the problem
and fix it. |
| 04/18/2005 |
08:26 |
PU |
381 |
E |
Legionnaires' disease should be included on the list of occupational respiratory diseases |
| 04/18/2005 |
07:29 |
PU |
377 |
E |
Much
more work needs to be done on residential construction, space environs,
and the quality of the breathing zones during daytime and nighttime
activities.
When I was at Johns Hopkins working on my doctorate, a professor from
China shared with us a study that he did on the impacts of lowering
ceiling heights and crowdedness and how the quality of the breathing
zone was adversely affected by lowering the polluted air zone so that
respiratory illnesses and allergic reactivity increased dramatically.
Much more attention needs to be given to the built development areas
including dams and reservoirs, highways, airports, mass transportation,
and other major construction projects that impact human health in so
many ways through vectors, flooding, water quality, injury prevention,
etc. Much more can be done to design in safeguards to better protect
public health and prevent adverse health outcomes from both natural and
human-caused events, including terrorism. CDC does little (minor token
work) to work with the other Federal and State agencies to safeguard
human health in the long term on projects affecting millions of people.
Is it acceptable that we should stand by and watch 60,000 or more die
each year in vehicular accidents with half of the deaths attributed to
some sort of alchohol involvement. Why is not more being done to
prevent fire deaths? Why are we not doing more to prevent obesity and
the diseases attributable to overeating? And so on... Bob Kay |
| 04/17/2005 |
18:16 |
PU |
373 |
E |
I suggest a well designed longitudinal study of the association between
environment and health outcomes. For example, asthma, autism, brain
tumors, etc. seem to be on the increase. We need a study to identif the
causes and how we can prevent these conditions and deaths. |
| 04/17/2005 |
12:20 |
PU |
369 |
E |
E1, E4 and E7 would seem to apply equally well to all parts of our
environment, including the workplace. If that is the intent, it should
be made clearer. If it is not the intent to include the workplace, then
they should be modified to clearly include the work environment. E3
specifically mentions "environmental and work settings" which is very
clear and appropriate. E2, E5, E6, and E8-E15 can easily be read to
include both at work and outside work issues, and that is the
appropriate message. If there is any chance others will not realize
both are included, then the language should be modified to make it
clear. Most of the examples provided in E16-E21 could be included in
one of the previous items to make it very clear that work and outside
work issues are both of interest and are conceptually integrated in
this agenda. However, none of the examples provided in E16-E21 should
be lost from the document in such a process. |
| 04/17/2005 |
11:36 |
PU |
368 |
E |
The
E9 Research Theme and Description is worded incorrectly, I believe.
Insert "and" before "suicidal;" delete the comma after "suicidal" and
insert "for" before "care" to avoid saying the theme is the prevention
of care for the acutely injured. Alternately, move "care for the
acutely injured" before the "prevention of" list. |
| 04/16/2005 |
22:05 |
PU |
367 |
E |
Efforts
to identify the factors which contribute to successful trauma systems
in terms of secondary injury prevention in the acutely injured patient
should be of high priority. Recommendations for trauma system
components are largely based upon anecdotal information. Determining
the factors which make a true difference should be paramount. |
| 04/15/2005 |
14:13 |
PU |
361 |
E |
The
greatest contribution CDC could make to the safety and health of the
public is to begin a dialogue on the delivery of health care in our
communities in a non-partisan, non-ideological, open discussion.
Promote objective reviews and educational forums to educate the public
on both the short-comings and the advantages of our current approach to
health care delivery. Leave no stones unturned. Review the AMA, the
health insurance companies, our legal system, the educational system,
and federal funding. Present alternative approaches that other
countries have employed to avoid our deficiencies and report
objectively their failures and successes. If the American public had
the objective information they need to evaluate our health care system,
we would not have the system we now have and millions of lives would be
saved annually. This is an annual loss greater than any plaque or war
our country has endured. This could be the number one accomplishment of
CDC in this century. |
| 04/15/2005 |
13:23 |
PU |
358 |
E |
Seems
skewed toward injury (10/21 topics)--is that because injuries, and
reductions in injuries, are easier to count than diseases?
Nothing on the chronic diseases (cancer, cardiovascular disease) that
are the two major causes of death in the US, nor on reproductive
disorders resulting from occupational exposures
Nothing on the role of gene-environment interactions in the development
of environmental and occupational disease
These two oversights are MAJOR gaps in the plan |
| 04/15/2005 |
12:28 |
PU |
355 |
E |
The
Emergency Medicine Network (EMNet, www.emnet-usa.org) at Massachusetts
General Hospital strongly supports the CDC’s Theme E 17 (Occupational
Respiratory Disease). EMNet has conducted extensive research on
emergency department (ED) visits for respiratory illnesses including
asthma and COPD. We encourage research aimed at reducing the incidence
of respiratory illness, but not just the relatively small subset due to
occupational exposures. The CDC research agenda might more directly
address the goals in Healthy People 2010: asthma (24-1 to 24-8) and
COPD (24-9 to 24-10). |
| 04/15/2005 |
12:11 |
PU |
353 |
E |
E1:
The starter list fails to recognize the distinction between indoor
environmental hazards and ambient exposures. The relative risks of
indoor vs. outdoor exposures need to be examined and resources should
be redirected accordingly. Monitoring tools need to be developed to
detect health hazards in housing -- and high risk housing units need to
be assessed for hazards before health is harmed. E2 The term
"susceptible populations" seems to suggest biological vulnerability.
The term "at risk populations" recognizes the reality that low-income
families are much more likely to suffer adverse health effects from
substandard housing and other environmental exposures. E5 The "built
environment," while a convenient umbrella term, is overly vague. It
tends to put people to sleep and camouflages the signficant health
hazards posed by substandard housing. Indoor environmental health
hazards related to substandard housing deserve special emphasis and
separate consideration. Substandard housing imposes disproportionate
risk on low-income families -- and stands as a compelling environmental
justice issue. Building DESIGN is only one aspect of the problem;
building MAINTENANCE deserves explicit mention. E6 "Health promotion
activities" is too vague a category. CDC and other federal agencies
agree that lead-based paint and dust hazards in housing are the
overwhelming cause of childhood lead exposure. Be more specific about
validating tools and strategies for screening high risk housing for
hazards (as well as screening children's blood for elevated lead
levels), policy interventions to protect children in highest risk
housing, confronting the "repeat offender" problem (houses that poison
multiple children), and building capacity for lead-safe work practices
and clearance testing. |
| 04/15/2005 |
09:54 |
PU |
352 |
E |
built environment and exposures form the past are important |
| 04/15/2005 |
09:54 |
PU |
351 |
E |
built environment and exposures form the past are important |
| 04/15/2005 |
06:50 |
PU |
344 |
E |
I
would like to submit a strong recommendation to focus research on the
sexual violence on peole with disabilities. The prevention of sexual
violence is a critical issue that needs ongoing support and research,
because the statistics are staggering. It certainly is a major public
health problem, that is silent. The estimated statistics of the
victimization of people with disabilities at least double those of
their peers without disabilities. |
| 04/14/2005 |
19:00 |
PU |
342 |
E |
These
are very important topics, though I am not sure why they are lumped
this way. Injury prevention seems to have its own life; in fact, when I
have tried to apply for "injury" grants to study occupational injuries,
I have been told that only NIOSH funds stuff related to occupation.
Will this change? |
| 04/14/2005 |
15:48 |
PU |
339 |
E |
Would like to see emphasis on environmental health disparites and inequity in environmental exposures. |
| 04/14/2005 |
14:42 |
PU |
338 |
E |
E5
- Built Environment and Health
This area is not currently given any consideration in our state health
department's environmental health group, though these issues may prove
to be as important to community and worker health as more traditional
environmental and occupational health issues. The potential impacts of
the built environment and land use decisions on health endpoints in the
general community and on health and productivity endpoints in the
workforce merit further investigation and adequate resources to promote
such research. By promoting this type of research priority as part of
the CDC Research Agenda, state health departments and research
institutions will have greater success in encouraging increased
emphasis on these issues, in relation to the more traditional
environmental and occupational health issues. This also may help
generate more funding opportunities in this area of research.
It would be advisable to expand this category of research to also
include research on the impacts of open or green space on community
health endpoints and workplace health and productivity endpoints. |
| 04/14/2005 |
14:18 |
PU |
337 |
E |
Again, this should be further down on the list! |
| 04/14/2005 |
14:18 |
PU |
336 |
E |
With
anticipation of an older workforce it is important to explore unique
injury risks of the aged, relationships between co-morbidity and
recovery from injury, the influence of psychosocial factors on injury
and rehabilitation, and susceptability of older workers to various
environmental exposures. |
| 04/14/2005 |
13:57 |
PU |
335 |
E |
My
comments are directed towards injury research. 1) CDC needs to abandon
its tendency to lump age groups into 5-year intervals. More
developmentally appropriate intervals that might be considered would be
separately categories for <1, 1-2, 3-4, 5-9, 10-12, 13-15, 16-17,
18-21. 2) CDC-funded research on childhood injury needs to go beyond
categorization of injuries as intentional or unintentional injury in
order to address child abuse issues. Recurrent injuries in abusive
families often include a combination of violence and neglect. Moreover,
both violence and neglect may lead to fatal injuries or longstanding
physical and mental problems in non-fatal injuries. Therefore,
classifying injuries as abusive (injuries due to violence and neglect)
and non-abusive should be utilized in CDC-sponsored research when
approaching child abuse rather than the frequently unrealistic
dichotomy between intentional ( or violent) vs. unintentional injuries.
3) CDC needs to promote methodologies that look at families as the unit
of interest rather than individuals. This is especially true for
children and adolescents less than 16 years old. Otherwise, injury
research on children and adolescents loses potentially valuable
insights into recurrent injuries among family members (such as the link
between child abuse and intimate partner violence and the association
of injuries due to violence and those due to lack of caregiver
vigilance). Given that the focus of any intervention would inevitably
be the family, it makes little sense to focus on the individual. 4)
Recognize that automobile safety is the paramount issue for teenagers.
This is true not only for teenage drivers but their passengers. (Most
fatalities among adolescent passengers occur in cars driven by other
teens.) CDC needs to fund studies that explore behavioral and cognitive
contributions in adolescent drivers. It will be important to use
methods that determine what teen drivers do, not what they say they do.
(Don’t waste taxpayer dollars using surveys such as BRFSS or post-crash
interviews for adolescent driving research, but fund research that
provides objective, realistic data on adolescent driving.)
|
| 04/14/2005 |
13:53 |
PU |
334 |
E |
I advocate for research priority for people with disabilities who fall victim to domestic and sexual abuse.
Thank you. |
| 04/14/2005 |
13:13 |
PU |
330 |
E |
Should
include a focus on environmental justice. Today the biggest
environmental risks are often from things like poor quality housing or
living on a heavy transportation route, things that are tied to poverty
and to minority communities. |
| 04/14/2005 |
12:36 |
PU |
327 |
E |
Please
investigate on substance abuse combining with injury prevention since
many emergency room visits (70%)- are tied to the use of a mind
altering substance. |
| 04/14/2005 |
12:07 |
PU |
321 |
E |
I
suggest we do a study of whether there is an spike in injuries or other
adverse effects right after the time changes to or from daylight
savings time. |
| 04/14/2005 |
11:04 |
PU |
314 |
E |
Regarding
E-16 "Occupational Injuries" research priority area: Examples of
research activities are provided, but FAIL TO INCLUDE occupational
safety and health training as a viable research intervention area. It
would be pertinent to mention such training as a viable research area.
In my own opinion, training can be sometimes overlooked, so including
it here may help to ensure that its importance is maintained. While
training, in a more general sense, could be included in the "Cross
Cutting Research" in sub-areas X-7(health educ, communicat, marketing),
X-10 (translation and dissemination of effective interventions), and
X-11 (workforce training and development), NONE of these sub-areas
specifically address OCCUPATIONAL SAFETY AND HEALTH TRAINING. |
| 04/14/2005 |
10:31 |
PU |
308 |
E |
Related
to community preparedness, there are still high rates of injury among
responsders to chemical emergency events (about 3,000 events per year).
What are the rates?
What are the rates among different groups?
What are the predictors of the rates? and what should our
recommendations be to reduce those rates? |
| 04/14/2005 |
09:45 |
PU |
300 |
E |
Eye safety in the workplace and in sports, especially for children. |
| 04/13/2005 |
18:52 |
PU |
293 |
E |
The
reaction of the general public, medical professionals, and
disability-related service providers to information about violence
against women with disabilities is often one of shock and disbelief, as
if they believe that disability is somehow a protective factor against
this epidemic social problem. Advocates and researchers in the field of
disability, on the other hand, are bringing to light case studies and
statistics that point to disability as a risk factor for intimate
partner violence (IPV) and sexual assault. Research out of Baylor
College of Medicine's Center for Research on Women with Disabilities in
Houston and other institutions indicate that intimate partners are the
most likely perpetrators against women with physical disabilities.
There is general agreement that disability introduces additional
vulnerability for violence into women's lives. Yet the CDC center on
injury prevention research has not identified this population as a
priority. With the exception of the Office on Disability & Health,
little to no attention has been paid to violence against people with
disabilities.
|
| 04/13/2005 |
17:56 |
PU |
292 |
E |
I
recommend that CDC seriously consider including a focus on primary
prevention of abuse against individuals with disabilities. The limited
available research documents that individuals with disabilities
(especially those with cognitive or other developmental disabilities)
face a high risk of abuse. There are few victim assistance programs in
the country that are addressing the problem of violence against persons
with disabilities; however, interest by disability advocacy, domestic
violence, and sexual assault programs in this area is increasing. In
2003, SafePlace in Austin, Texas, conducted a national survey on
accessibility of domestic and sexual violence programs. The results
indicated that few people with cognitive, physical, sensory or other
developmental disabilities are accessing violence intervention
services. Relatively little research has been conducted in the US on
the issue on violence against persons with a wide range of disabilities
or the efficacy of primary prevention efforts for this population. Most
of the research on this topic is from Canada. If I can be a resource in
any way to CDC on this topic, please feel free to contact me,
Wendie Abramson
Director of Disability Services SafePlace
P. O. Box 19454
Austin, Texas 78760
(512) 356-1599
wabramson@austin-safeplace.org |
| 04/13/2005 |
16:37 |
PU |
291 |
E |
Risk
and Protective Factors for Children with Developmental Disabilities.
For children with developmental disabilities, identify the risk and
protective factors and effective interventions associated with the
leading cause of child maltreatment/abuse/victimizations. 1) Identify
pathways to violence and identify risk factors associated with such
behavior
2) Identify protective factors believed to buffer risk, such as fully
integration in schools and community (not isolated) and education about
abuse and how to stay safe. |
| 04/13/2005 |
16:22 |
PU |
289 |
E |
Is
there any intention of looking at the Innovative pilot projects that
EPA/OSWER is or has developed in this area and community preparedness? |
| 04/13/2005 |
16:06 |
PU |
288 |
E |
The
Environmental Research Themes are all focused on exposure metrics;
however, there are many health outcomes with possible environmental
etiologies. Special emphasis should be placed on obtaining nationally
representative prevalence or incidence of these diseases (e.g.
neurologic, reproductive, environmental disruption, respiratory).
The Injury Research Themes are overrepresented, repetitive, and not
efficiently identified. E11, E12, E14, E15 could all be combined into
one theme about injury prevention for communities, families, parents,
children, and adolescents. Comes across as self-serving and protective
of CIO research agendas within NCIPC divisions. This is not the purpose
of the CDC Health Protection Research Guide, 2006-2015. I would leave
this type of theme development at the CIO level.
The Occupational Research Themes likewise could be collapsed. E16 and
E18 both address interventions for occupational and musculoskeletal
injuries and can be combined. |
| 04/13/2005 |
15:49 |
PU |
286 |
E |
Another
inclusion, which may be considered, in research priorities in the
Environmental Health Intervention section is the standardization of
health indicators in environmental justice areas. I propose the
following to be studied for inclusion as a standard: Rates of Age
adjusted non-cancer mortality rate-rate per 100,000; Age adjusted
cancer mortality rate-rate per 100,000; Infant mortality rate-rate per
100,000; Low birth weight-rate per 100,000; Mortality rate per 100,00
of disease of contamination and disease incidence rate per 100,000 per
year, (Prevalence rate may be calculated for years of contamination). |
| 04/13/2005 |
07:49 |
PU |
266 |
E |
Research
Priority Areas: National Vision Program/ CDC/ Division of Diabetes
Translation
CDC/DDT/NVP
E 1 Environmental Risk Factors
• Increase the understanding of the interaction between health and the
environment.
1. CDC/ NVP may examine the role that chronic lead exposure has on the
development of cataracts and age-related macular degeneration.
2. CDC/ NVP may look at other chronic environmental exposures, multiple
stressors and their possible relationship to the maintenance of ocular
health.
E 7 Environmental Data and Information Systems
• Develop methods and tools to link available environmental hazards and
health outcome databases.
1. CDC/DDT/NVP plans to use epidemiologic, statistical and programmatic
methods and tools to link available information across databases and
data sources involving lead exposure and the presence of cataracts and
or age-related macular degeneration.
E 11 Risk and Protective Factors of Adolescent Unintentional Injury
• For adolescents, identify the risk and protective factors and
effective interventions associated with the leading causes of non-fatal
injuries.
1. CDC/DDT/NVP will be working toward identifying and reducing risk
taking behaviors related to eye injuries and youth.
2. CDC/DDT/NVP efforts targeted at HP 2010 focus area 28.8 and 28.9.
E 16 Occupational Injuries
• Identify the multiple factors and risks that contribute to
occupational injuries and develop and evaluate effective interventions
for reducing such injuries.
1. CDC/DDT/NVP will be working toward identifying and reducing risk
taking behaviors related to occupational eye injuries.
|
| 04/12/2005 |
14:51 |
PU |
264 |
E |
•
Environment and Occupational Health and Injury Prevention: Consider the
role of saliva-based diagnostics under E3 and E6 and the role of the
dental staff in detecting and reporting domestic violence. Consider
expanding environmental toxin exposure detection through salivary
diagnostics and oral lesions. |
| 04/12/2005 |
11:56 |
PU |
263 |
E |
The
group should be commended for its work putting these together. The
Injury Research Center at the Medical College of Wisconsin believes
that the workgroup has touched on many of the broad issues in the field
of injury control and prevention research. One recommendation to
strengthen the list is to consider broadening Theme #E11 to identify
the risk and protective factors of unintentional injury across the age
span. There are many unknown factors that cause injury to be the
leading cause of death for people 1-44 years old. While this includes
adolescents, it also includes children and adults, and these risk
factors are very different than for adolescents. Also injuries are a
primary cause of illness and death for the elderly as well, with
injuries falls, motor vehicle crashes, and suicide being the leading
cause of injury death in people over 65 years. With regard to Theme
#13, consider adding a possible research strategy to identify and
evaluate components of post-hospital care that contribute to
improvements in outcomes for the injures. Additionally, consider adding
an activity to "develop and evaluation acute injury treatment
strategies for management of injury" (from draft Acute Care Injury
Reserach Agenda). The addition of this activity helps strengthen the
Theme by both looking at the components of the trauma system but also
identifying evidence-based treatment strategies that health care
professional utilize to maximize outcomes. Thank you for the
opportunity to comment. --- Injury Research Center at Medical College
of Wisconsin. |
| 04/12/2005 |
10:36 |
OH |
262 |
E |
As
a participant in the EOHIP Research group, with a special interest in
Environmental aspects, I was disappointed by the focus of the breakout
group, which was heavily weighted towards Occupational Health and
Injury Prevention issues. This in no way reflects on CDC but rather on
the make-up of this all-volunteer group, which had only 2 or 3
Environmental proponents. What was particularly disturbing was the
attitude of the other participants, who felt that there was no longer
any need to conduct research, as the main problem nowadays was rather
to get existing information about environmental health out to the local
communities. As a researcher in the environmental area, with a special
interest in Human Exposure Assessment issues, I have worked and
continue to work with NCEH/DLS researchers on a variety of problems in
this field. I feel it is particularly important, therefore, to
emphasize that research work at CDC in environmental health, including
human exposure, should continue and, if anything, should increase. The
documents that resulted from the efforts of the EOHIP group in Columbus
on March 31 did not reflect this concern or interest.
Sydney M. Gordon, D.Sc.
Research Leader
Battelle Memorial Institute
|
| 04/12/2005 |
10:30 |
PU |
261 |
E |
In
this area, critical attention must also be given to the effects public
policies , industry influence, and conflicts of interest have in
shaping the built environment (both at workplace and community level
that in turn lead to increased occupational exposures, injuries, and
adverse health outcomes. |
| 04/11/2005 |
22:17 |
PU |
260 |
E |
The
starter list is fine, though priorities within can be esatblished. I
would say that biomonitoring, chemical mixtiures are important areas
for epidemiologic research in workplace and communities. An explicit
emphasis on imrpoving biomarkers of exposure, response (early), and
susceptibility should be explored. It is important to note that this
effort can dovetail with bio- and chem terrorism prevention work.
|
| 04/11/2005 |
16:45 |
PU |
259 |
E |
There
is an urgent need for research into the impact of smokefree workplace
policies on employee secondhand smoke exposure, employee health,
employer cost savings (in terms of both health care costs and
productivity), and sales, revenue, and employment (for hospitality
workplaces such as restaurants, bars, and casinos). An unprecedented
number of U.S. communities and states, as well as a number of foreign
countries, are enacting smokefree workplace laws, and many employers
are adopting voluntary smokefree workplace policies. While a strong
evidence base exists that these policies reduce employee secondhand
smoke exposure, improve employee health, and have a neutral or positive
impact on hospitality revenues, sales, and employment, the development
of standardized, simple protocols and the provision of technical
assistance are needed to help practitioners implement such studies at
the local and state levels, since policymakers frequently ask for local
data. There is also a need for more specialized studies looking at
specific topics such as the impact of smokefree workplace policies on
employer cost savings, the impact of these policies on rates of
hospital heart attack admissions, and the economic impact of these
policies on gaming venues. |
| 04/11/2005 |
14:06 |
PU |
257 |
E |
There
should be an additional theme in the Enviornmental and Occupational
Health and Injury Prevention List of Research Priorities.
Research Theme Title and Description:
Water and Health
Develop and evaluate health promotion interventions to reduce
waterborne disease in the United States and in other developed
countries.
Examples of Research Activities:
Increase detection and reporting of water-related outbreaks, sporatic
health and contamination events, and identify emerging contaminants by
defining clinical diagnostic needs and increasing clinical diagnostic
capacity for waterborne diseases.
Improve water-related outbreak and sporadic health and contamination
event investigations by defining environmental risk factors and
antecedents for water-related and contamination events, defining
essential needs, competencies, and standards of water and waste-water
environmental health programs.
Decrease the number of water-related outbreaks and sporadic health and
contamination events by developing a systematic approach for reducing
prevalence of key water-related health and contamination risk factors
and antecedents and be developing appropriate public health work force,
general public, and environmental interventions.
Assess the magnitude and burden of acute and chronic health effects,
and risk of illness associated with exposure to water-associated
contaminants or treatment by-products by establish and fund CDC
WaterNet (similar to and compatible with FoodNet) to answer
water-specific surveillance, epidemiologic, behavioral, and
environmental health research questions and identifying emerging public
health issues.
Assess the magnitude and buden of acute and chronic health effects, and
risk of illness and decreased water quality associated with use and
re-use of human and animal wastewater, stormwater, and septage by
developing and improving affordable and rapid dsmpling and diagnostic
tests to detect, differentiate, quantify, or measure exposures.
Assess the impact of water intervention projects on public health.
Create a national clearinghouse for educational information on
water-related health effects, exposures, and prevention. |
| 04/11/2005 |
12:01 |
DC |
256 |
E |
These
categories should not be combined. It dilutes attention from
work-related injuries and illnesses with attention to non-work related
injuries. |
| 04/11/2005 |
10:15 |
PU |
253 |
E |
Janet
Saul jsaul@cdc.gov and her colleagues at USC have twice convened
leaders from the fields of child maltreatment and youth violence to
share lessons learned and experiences. While the meetings were oriented
around a dissemination framework that is being developed, much of the
discussion would help inform the creation of a national research
agenda. I would recommend your getting input from her team (in the
event this step has not already occurred). |
| 04/11/2005 |
09:59 |
OH |
251 |
E |
see general discussion comment below |
| 04/11/2005 |
09:23 |
PU |
240 |
E |
Please
consider research that doesn't separate work-related exposure/illness
from community environmental exposure/illness. Often, community members
are exposed to the same contaminants as workers in a nearby industry.
It would be nice to study them together!! |
| 04/08/2005 |
16:45 |
PU |
236 |
E |
G16
- SAFE WATER is more appropriately placed in environmental health.
Also, on the water issue I have the following recommendation: Research
Theme & Title Description
WATER and HEALTH
Develop and evaluate strategies to translate, disseminate and sustain
science-based best-practices for improving drinking water, treatment of
waste water and monitoring recreational waters
Examples of Research Activities
o Improve water-related health and contamination event detection.
o Improve water-related health and contamination event investigations
o Assess the magnitude, burden, acute and chronic health effects, and
risk of illness associated with use of water-associated contaminants or
treatment by-products
o Assess the magnitude, burden, acute and chronic health effects, and
risk of illness and decreased water quality associated with use and
re-use of human and animal wastewater, septage, and biosolids
o Develop and improve affordable and rapid sampling and diagnostic
tests to detect or quantify known and emerging waterborne contaminants
or exposure to these contaminants
o Assess the impact of water intervention projects (e.g., fluoridation,
Legionella and monochloramine use) in community settings
|
| 04/08/2005 |
08:45 |
PU |
232 |
E |
The
title of this category doesn't seem to fully incorporate all the
sub-sections included. For example, I would not think that family
violence would fit under this category, although the description seems
to suggest it would and there is no other category it would seem to fit
into better. Perhaps "environmental and occupational health" and
"injury and prevention research" should be different categories? Or
change the title to "environmental, familial and occupational health"?
Something more inclusive... |
| 04/08/2005 |
08:41 |
PU |
231 |
E |
The area of biomonitoring is understated. Ask the public and they will tell you, test the people. |
| 04/08/2005 |
07:39 |
PU |
230 |
E |
Theme
E1: Focus on the impact of Secondhand Smoke in Outdoor Public
Environments. Impact of exposure in a variety of venues, RR, employee
(such as restayrant patio), SHS exposure related disease rates in
states with significantly restrictive policies versus those with
pre-emption and those without formal policy.Adoption of SHS policy is
perhaps the single most significant method to reduce SHS exposure, spur
cessation and prevent initiation among ALL populations. States like
California have proved this. It must be supported with irrefutable
research from CDC. |
| 04/07/2005 |
19:03 |
PU |
227 |
E |
Injury
Prevention Research is buried in this genreral category. Since injury
and violence continue to be the leading causes of death and disability
among the population less than 25, a separater category is warranted.
In addition to evaluation of exisitng prevention efforts, there should
be some emphasis on policy changes and the effects of these policy
changes on the magnitude and outcome of injury prevention strategies.
We continue to talk about prevention, but there has been little focus
on the ways in whiich young men are raised, and differences in
expectations of young boys vs. young girls.
The also needs to be a foucs on community norms and community level
change to impact the levels of both intentional and unintentional
injuriy. |
| 04/07/2005 |
16:11 |
PU |
225 |
E |
Please consider second hand exposure to tobacco smoke in workplaces... |
| 04/07/2005 |
15:59 |
PU |
224 |
E |
E.12 - Include identification of pathways that address differences in self-esteem levels and exposure to comprehensive education |
| 04/07/2005 |
13:47 |
PU |
217 |
E |
Motor vehicle and pedestrian injuries |
| 04/07/2005 |
11:47 |
PU |
215 |
E |
Develop
a Heavy Metals Research group. This will be a niche for CDC/ATSDR as we
do not currently have such a group.There are a lot of hazardous waste
sites that deal with heavy metals especially lead. For example: At
ATSDR/DHS- we currently are working on hazardous waste sites in Ohio,
Omaha, Idaho, and India dealing with following heavy metals -Beryllium,
Arsenic, Manganese, lead, and cadmium. |
| 04/07/2005 |
10:05 |
PU |
208 |
E |
E20
- Organization of Work
Good public health starts at home, i.e., here, at CDC.
The federal government has mandated teleworking for federal employees
via the telework law sponsored by Rep. Frank Wolf of Virginia.
This law is followed only sporadically here at CDC. It appears that
this law is not followed by many middle managers and that senior
management is allowing this to happen. I have even heard a rumor that
middle managers have ASKED senior managers to downplay the telwork law.
Surely this can't be true--that CDC management would conspire to ignore
federal law.
The benefits of telework are numerous and are detailed on the federal
telework website (www.telework.gov). Some CDC groups have telework.
Other groups that perform similar tasks don't--and it seems to be up to
the whim of individual managers, and that is FRUSTRATING to those who
are repeatedly denied the opportunity to telework.
|
| 04/07/2005 |
09:57 |
PU |
206 |
E |
I
strongly recommend that injury prevention be separated from
environmental and occupational health, as they are often quite
distinct. Injury includes intential and non-intentional injuries, and
occurs outside of a workplace far more frequently than at work. I also
think it would be helpful for intential injuries to be labelled as
"violence," and for all violence prevention and intervention (from
child abuse to terrorism) to be looked at together. There are many
overarching themes that connect various areas of violence that we can
learn from. I am also very concerned that the current focus on
international terrorism distracts us from the tremendous problem of
domestically-generated violence (child abuse, teen violence, intimate
partner violence, elder abuse, sexual assault, gun violence) faced by
Americans. |
| 04/07/2005 |
09:40 |
PU |
204 |
E |
I
see very little that addresses research of injuries in the home
environment or while participating in leisure activities. The CDC NCIPC
Research agenda identifies a need to study the epidedmiology, other
biomedical sciences, biomechanics and other engineering sciences,
social sciences and economics in seven key areas. It doesn't seem that
the proposed CDC research agenda incorporates all seven areas and
essentially leaves out "preventing injuries at home and in the
community" and "preventing sports, recreation and exercise (SRE)"
injuries. |
| 04/07/2005 |
09:19 |
PU |
201 |
E |
Since
Lott and Mustard's concealed carry laws have been largely dismissed as
biased, we need to revisit gun violence as an increase in should be
predictable. We should assess impact of Mercury exposure downwind of
bleach and coal fired plants, as well as the employees at such plants. |
| 04/07/2005 |
08:14 |
PU |
194 |
E |
Suggest
adding another research theme focused on the adverse health effects of
exposure to asbestos: Design, implement, and evaluate environmental
health interventions and health promotion activities that address
asbestos exposure |
| 04/07/2005 |
08:05 |
PU |
193 |
E |
I
fully support a special emphasis on Adolescents in the CDC Injury
Research Objectives, as stated. Over 75% of adolescent deaths are
related to injuries, and adolescent injury deaths are the primary
source of DALY lost. MV injuries in particular are the leading cause of
death in teens-- two out of five deaths among U.S. teens are the result
of a motor vehicle crash. Getting behind the wheel or riding with a
newly-licensed friend are everyday occurrences for teenagers, yet these
acts pose some of the greatest health risks that many teens will face
in their lifetime. Add to this, an annual estimated economic cost of
$40.8 billion. Teenage drivers are also responsible for the deaths and
injuries of their passengers, occupants of other vehicles, and
non-occupants such as pedestrians or bicyclists. Nearly 60% of the
people killed in crashes involving young drivers are not the young
drivers themselves. Many of the passengers involved in crashes with
young drivers are also teens. Researchers have identified important
risk factors for inexperienced teen drivers including nighttime
driving, carrying teenage passengers, lack of use of seat belts, and
alcohol use. Little is known, however, about the social or behavioral
processes and settings that influence how inexperienced teens learn to
drive, particularly those factors and interactions that foster safe
driving practices within this population. Such research is needed to
guide the development of interventions that parents, adolescent peers,
educators, health care providers, and others could use to promote safe
driving among teenagers. Ruth Shults, PhD, MPH
Captain, U. S. Public Health Service
Injury Center
Centers for Disease Control and Prevention (CDC)
4770 Buford Highway, NE, Mailstop K-63
Atlanta, GA 30341
USA
phone: 770 488-4638
email rshults@cdc.gov
|
| 04/07/2005 |
07:53 |
PU |
192 |
E |
I'm particuarly glad to see E-5 on the list. |
| 04/07/2005 |
06:45 |
PU |
190 |
E |
Especially
exposure to toxic substances and health effects on health within and
outside the workplace should be considered an important agenda item. A
number of situations have occurred already that resulted in specific
CDC intervention in addition to the NHANES studies. |
| 04/06/2005 |
15:23 |
OH |
183 |
E |
CDC
Research Agenda Development
Public Participation Meeting
Thursday, March 31, 2005
Hyatt Regency Columbus
Columbus, Ohio
Additions to CDC’ starter list of research priorities for Environmental
and Occupational Health and Injury Prevention Research:
Research Theme: Child Abuse and Neglect Prevention Research
Best practices and clarification around what works. What’s out there
in terms of prevention programming? Is it effective? What are the costs
and benefits in prevention programs? What prevention programs exist
beyond home visiting?
Cost-Benefit Research on prevention programs to show funders and
legislators why programs are doing what they do.
Ideas for having a common set of data items that similar prevention
programs like home visiting programs for example, all collect to
facilitate comparability of findings.
Invest in research-practice collaborations---bring together
researchers and practitioners to discuss challenges and findings from
our work in better understanding child maltreatment and prevention.
Better ways to measure what we do---we need more practice-based
evidence in addition to evidence-based practice i.e., we need to hear
from practitioners what is working and why they think programs are
effective. Practitioners need to be engaged in demonstration of why
programs work. Ways for agencies doing prevention work (and who have
varying degrees of sophistication and resources) can evaluate their
work in a meaningful way. Research on the application of a Life
Course Health Development (LCHD) framework to healthcare delivery. The
LCHD model suggests a person’s health development takes on a trajectory
that results from the cumulative influences of multiple risk and
protective factors as well as specific influences that are programmed
into that individual’s regulatory system during critical periods in
development. How can factors such as social environment and family
interactions operating “outside” of the body have an effect on the
biological and physiological system “inside” the body? What are the
long-term effects of psychosocial factors on the biological and
physiological system?
Research on marketing and educational campaigns---what is and isn’t
working?
Research on the overlap between domestic violence, mental illness,
substance abuse, and child abuse and neglect.
Research on how program implementation affects child health outcomes.
Research on reframing child abuse and neglect and research on the
implementation of reframed messaging of child abuse and neglect. Have
a web-accessible repository of prevention programs, innovations,
strategies, practices.
Research on State-National Organizations with a credentialing or
chartering process (e.g., Prevent Child Abuse America Chapters) and
impact on reducing child abuse and neglect:
_ Cost-effectiveness of credentialing/chartering
_ Research on fundraising---what is effective and most efficient
_ Is computerized/electronic types of data gathering more
effective/helpful to prevention?
For example, what is key to helping Prevent Child Abuse America
chapters with the above would be an opportunity to acquire unrestricted
funding i.e., “seed money” into our Research Center to do this type of
basic evaluation consultation. Submitted by:
Domarina Oshana, PhD
Director
National Center on Child Abuse Prevention Research
Prevent Child Abuse America
200 S. Michigan Avenue, 17th Floor
Chicago, IL 60604-2404
Tel. 312.663.3520, ext. 805
DID: 312.334.6805
Fax 312.939.8962
doshana@preventchildabuse.org
http://www.preventchildabuse.org |
| 04/06/2005 |
13:57 |
PU |
182 |
E |
I
suggest partnering with the Department of Defense regarding acoustic
trauma and noise-induced hearing loss (NIHL). Many citizen soldiers
(Reserve and National Guard) are returning from military deployment to
their more traditional workplace with significant hearing loss due to
either acoustic trauma or NIHL. Prevention, treatment and
rehabilitation programs must be improved. |
| 04/06/2005 |
11:10 |
PU |
181 |
E |
ENVIRONMENTAL AND OCCUPATIONAL HEALTH AND INJURY PREVENTION RESEARCH:
CHILD ABUSE AND NEGLECT IN AMERICAN INDIAN/ALASKAN NATIVE COMMUNITIES
(BRIEFING PAPER)
Issue
Child abuse and neglect have serious health implications for American
Indian and Alaskan Native (AI/AN) children, families and communities.
These communities encounter child abuse and neglect in rates that are
higher than children from other racial groups. There is much evidence
that the environment in which Ai/AN children live has much to do with
these higher than average rates. The National Indian Child Welfare
Association (NICWA) has for several years investigated and publicized
environmental interventions that can reduce the incidence of abuse and
neglect in Indian Country. This area of prevention should be included
in the CDC Starter List of Research Priorities. Background
The available national data on child abuse and neglect affecting AI/AN
children comes primarily from state agencies, although tribes and other
federal agencies, such as the Indian Health Service and the Bureau of
Indian Affairs, also collect data. Data from state agencies, which are
involved in about 61% of child abuse cases (Earle, 2000), found in the
National Child Abuse and Neglect Data System show that AI/AN children
are abused at rates that are higher than the national average for all
other children. These rates are estimated, given the lack of data, to
be even higher than those reported (Fox, 2003). Tribal data would only
be available by surveying individual tribes, which has not been done at
this time. Definitions of abuse and neglect are diverse and include
such categories as physical or sexual abuse and physical, emotional,
medical, educational or institutional neglect. Definitions shape how we
perceive abuse and neglect and how we respond. States and tribes have
the authority to create their own definitions, which may be similar or
vary significantly. Historically, mainstream definitions or
interpretations of child abuse and neglect among AI/AN children have
often led to inappropriate removals of these children from their
families based upon cultural perceptions that were biased or false. In
some cases, protective factors for preventing abuse among AI/AN
children have been interpreted by public agencies as deficits that
created risk for child abuse and neglect. As an example, the role that
extended family play in helping care for and protect AI/AN children
from abuse and neglect has been interpreted by some public child
welfare workers as neglect or abandonment when the children were not
living in the home of their biological parents. These types of
practices were widespread and well documented in the 1960’s and 70’s by
the Association on American Indian Affairs. They became the catalyst
for enactment of federal legislation that would define procedures and
requirements for the removal of AI/AN children by private and public
child welfare agencies (U.S. House Report, 1978). The legislation, the
Indian Child Welfare Act (P.L. 95-608), also led the way to further
involvement of tribes in child custody proceedings involving their
children to help state courts and public and private agencies make
better child welfare decisions. Natural systems that originate from
tribal cultural beliefs and practices that helped protect AI/AN have
been marginalized or disrupted in AI/AN communities. Examples of these
include the forced removal of children and placement in assimilationist
boarding schools in the 19th and 20th century, the adoption of hundreds
of Ai/AN children to non-Indian families in the 1950’s and 60’s through
the Indian Adoption Project and the prohibition on the practice of
tribal religions by the federal government on many reservations during
the 19th and 20th century (George, 1997; Cross, 1986; Hull, 1982). As
we look at how child abuse and neglect affects AI/AN children, families
and tribal communities it is important that the cultural context is
well understood and how that impacts perceptions and responses to child
abuse and neglect both in and
outside of tribal communities.
Other factors that play a role in the risk for child abuse and neglect
in AI/AN communities include poverty, rates of alcohol and substance
abuse, single-parent households, children who lack prenatal care,
children with disabilities, and children of teen parents. AI/AN
communities have some of the highest poverty rates of any racial group
in the United States. The census data make it clear that, despite
increased tribal income from the 1990 to the 2000 census, “On average,
Indians on both gaming and non-gaming reservations have a long way to
go with respect to addressing the accumulation of long-enduring
socioeconomic deficits in Indian Country. Across many indictors – even
those displaying remarkable improvement – the gap remained large in the
2000 census: Real per capita income of Indians living in Indian Country
was less than half the U.S. level; real median household income of
Indian families was little more than half the U.S. level; Indian
unemployment was more than twice the U.S. rate; Indian family poverty
was three times the U.S. rate; the share of Indian homes lacking
complete plumbing was substantially higher than the U.S. overall level;
and the proportion of Indian adults who were college graduates was half
the proportion for the U.S. as a whole” (Taylor & Kalt, 2005, p.
xii). The authors also caution that the gains made in the past decade
could easily be eroded if the policies of self-determination are not
protected. While poverty alone is not an indicator of risk for abuse it
does present additional stressors for families that are living below
the poverty level. While AI/AN people as a group have some of the
highest sobriety rates, alcohol and substance abuse is still prevalent
in many communities and contributes to the risk for child abuse and
neglect. In a recent study a third to almost half of AI/AN children in
13 states lived in female-headed households where the single caregiver
was without stable employment (Willeto, 2002). The rates of inadequate
prenatal care for American Indian and Alaska Native mothers in
1989-1991 was almost twice the rate of Whites with 18.1% of rural
pregnancies and 14.4% of urban pregnancies for American Indians and
Alaska Natives occurring without an adequate pattern of prenatal care
(Baldwin, Grossman, Casey, Hollow, Sugarman, Freeman & Hart, 2002).
AI/AN populations have a teen birth rate of 41.4 births per 1,000
females, compared to 29 births per 1,000 females for all population
groups (Willeto, 2002). The presence of these risk factors and the
rates at which they occur indicate that many AI/AAN communities will
have high risk levels for child abuse and neglect.
Prevention: Protective Factors
Yet there are beginning indicators of factors that protect children
from abuse. In tribal communities these include activities, values and
attitudes that were developed decades or even centuries before contact
with the western world. They work to prevent or ameliorate the effects
of abuse despite many of the negative factors such as alcoholism,
poverty, single parenthood and teen pregnancy cited above. Some of
these protective factors appear, for example, in a list of strengths
developed by NICWA and five tribal communities for a pilot
abuse/neglect reporting system. They include: extended family support;
community support and involvement; access to resources and tribal
community programs; adequate medical services; adequate transportation;
ability to economically support; subsistence planning and preparation;
religious/spiritual practices; positive self esteem; positive
motivation; alcohol and drug free; good health practices; good
hygiene/appearance; positive elder access; problem solving and decision
making skills; parenting skills. These are, in many cases, attributes
which can be learned or resources that can be provided. What works in
Indian Country is directly related to how well tribes can combine their
proven cultural approaches to child abuse and neglect with more modern
technology and resources. NICWA has also, over the past several
years, provided training in Positive Indian Parenting (PIP) to tribal
communities. With a primary emphasis on strengths rather than problems,
NICWA is working to identify the interaction of prevention factors with
the incidence of abuse and neglect in tribal communities. Summary
The available data indicate that child abuse and neglect are serious
problems in Indian Country that threaten child, family and community
functioning. The health threats are both immediate and long term.
Tribal governments have the authority and responsibility to address
this serious health issue, and there are beginning indicators of
elements of prevention that may be used in these efforts. There is much
talk and publicity regarding “Evidence Based Practice” (EBP). The
elements of EBP, however, appear to best serve mainstream rather than
tribal communities. Indian Country and NICWA have begun to respond by
delineating what works best for our population. This is a nascent
effort, and needs the support and encouragement provided by federal
priorities and funding opportunities to be thoroughly investigated.
Greater attention to these efforts and commitment to supporting them
will help tribal programs revitalize the protective factors and helping
systems that have been proven over time.
References
Baldwin L. M., Grossman D. C., Casey S., Hollow W., Sugarman J. R.,
Freeman W. L., & Hart L. G. (2002). Perinatal and infant health
among rural and urban American Indians/Alaska Natives. American Journal
of Public Health, 92(9) 1491-7.
Bohn, D. K. (2003). Lifetime physical and sexual abuse, substance
abuse, depression, and suicide attempts among Native American women.
Issues in Mental Health Nursing, 24(3), 333-352.
Child Welfare League of American (CWLA). (1999). Child Abuse and
Neglect: A Look at the States. 1999 CWLA Stat Book. Washington D.C.:
CWLA Press.
Cornell, S. & Kalt, J.P., (1998). Sovereignty and Nation-Building:
The Development Challenge in Indian Country Today American Indian
Culture and Research Journal 22, no. 4.November 1998.
Cross, T. L. (1986). Drawing on cultural tradition in Indian Child
Welfare practice. Social Casework, 67, 283-289.
Dexheimer P. M., Resnick, M. D, & Blum, R. W., (1997). Protecting
against hopelessness and suicidality in sexually abused American Indian
adolescents. Journal of Adolescent Health, 21(6), 400-406.
Earle, K.A. (2000) Child Abuse and Neglect: An Examination of American
Indian Data. Seattle, WA: Casey Family Programs.
Fox, K.A. (2003). Collecting data on the abuse and neglect of American
Indian children. Child Welfare, 82, 707-726
George, L. J. (1997). Why the need for the Indian Child Welfare Act?
Journal of Multicultural Social Work, 5(3/4), 165-175.
Hull, Jr. G. H. (1982). Child welfare services to Native Americans.
Social Casework, 63, 340-347.
Indian Health Services, Department of Health and Human Services (1997).
Trends in Indian Health. Author.
Kendall-Tacket, K. (2002). The health effects of child abuse: Four
pathways by which abuse can influence health. Child Abuse and Neglect,
26, 715-729.
Nelson, K. E., Saunders, E. J., & Landsman, M. J. (1993). Chronic
child neglect in perspective. Social Work, 38(6), 661-671.
Red Horse, J.G., Martinez, C., & Day, P. (2001). Family
preservation: A case study of Indian tribal policy. Seattle, WA: Casey
Family Programs.
Stevenson, J. (1999). The treatment of the long-term sequelae of child
abuse. Journal of Child Psychology and Psychiatry, 40(1), 89-111.
Taylor, J. B., & Kalt, J. P. (2005). American Indians on
reservations: A databook of socioeconomic change between the 1990 and
2000 Censuses. Retrieved January 19, 2005, from Harvard University,
Harvard Project on American Indian Economic Development Website:
www.ksg.harvard.edu/hpaied/documents/AmericanIndiansonReservationsADatabookofsocioeconomicchange.pdf
U.S. Department of Health and Human Services, Administration on
Children and Families (2003). Child Maltreatment 2001. Washington DC:
US Government Printing Office.
United States Department of Health and Human Services, Administration
on Children, Youth, and families (2004). Child Maltreatment 2002:
Reports from the States to the National Child Abuse and Neglect Data
Systems. Washington, DC: US Government Printing Office.
U.S. House Report. (1978). No. 1386., 95th Congress, 2nd Session.
Establishing standards for the placement of Indian children in foster
care or adoptive homes, to prevent the breaku0p of Indian families,
July 24, 1978. Washington, D.C.: United States Government Printing
Office.
Willeto, A. A. A. (2002). Native American Kids 2002: Indian children's
well-being indicators data book for 13 states. Report available from
Casey Family Programs, 1300 Dexter Avenue North, Seattle, 98109, or
from the National Indian Child Welfare Association. |
| 04/06/2005 |
09:44 |
PU |
180 |
E |
In
rural and agricultural areas, children are at high risk of unique
disease/injury conditions. Research is needed to understand barriers to
protective environments for children; and research is warranted to test
interventions that would separate children from
environmental/occupational exposures (e.g. what incentives will prompt
parents to put children into child care programs versus be present in
barn while adults are working?). Research is needed to identify policy
options for improving safety practices among agricultural workers (e.g.
what government or insurance policies might effectively impact safety
practices in agriculture?) |
| 04/06/2005 |
08:33 |
PU |
177 |
E |
Motor
vehicles are the number one cause of trauma deaths world wide,
surpassing the toll taken by the casualties of war. Pedestrian injuries
are particularly pernicious, disproportionately affecting the youngest
and oldest members of our communities. Research is needed to establish
evidence-based interventions to guide local efforts to prevent and
control these injuries.
Thanks for the opportunity to comment.
C. DiMaggio
|
| 04/05/2005 |
23:13 |
PU |
175 |
E |
important to determine body burden of chemicals and and toxic elements |
| 04/05/2005 |
15:05 |
PU |
170 |
E |
the
CDC has establisheds a strong program of research on child maltreatment
that is advancing the field in several highly problematic areas. I
would strongly urge the CDC to expand this area of research and
continue to provide leadership to the field. |
| 04/05/2005 |
14:44 |
PU |
168 |
E |
Currently,
there is little information about safe dermal exposure levels to
potentially harmful chemicals that exist as particles or aerosols. This
information should be developed to permit assessment of health risk,
and the need for engineering controls or PPE. |
| 04/05/2005 |
13:14 |
PU |
161 |
E |
Include
Trauma Centers in your funding priorties. They will be responding to
all terrorist and environmental challenges and the resources for Trauma
Centers currently is overtaxed and needs support. |
| 04/05/2005 |
12:38 |
PU |
160 |
E |
I
would like to see funding to evaluation the efficacy of specific injury
prevention program (s). There are many "Canned" programs available but
very few have been proven by evidence based research. |
| 04/05/2005 |
07:26 |
PU |
158 |
E |
Priorities within content areas would do well to be data driven
The disparities priorities should include individuals with disabilities
The work already done here is very good |
| 04/04/2005 |
13:30 |
PU |
156 |
E |
Conflicts with other federal agencies (e.g., OSHA). Would siphon monies and interest from other areas. |
| 04/04/2005 |
12:20 |
PU |
154 |
E |
Research
the attitudinal, knowledge, and behavior change before and after
presenting the ThinkFirst educational program-- presented by injury
prevention specialists and people who have had brain and spinal cord
injury-- through the National Injury Prevention Foundation, or one or
more of their state chapters, such as our IL chapter at Central DuPage
Hospital. For more info-- debby_gerhardstein@cdh.org |
| 04/04/2005 |
11:34 |
PU |
151 |
E |
Since
injuries are the leading cause of years of potential life lost, the
leading cause of death for ages 1-44, a leading cuase of
hospitalization, and a leading cause of emergency department visits,
more money and time should be spent in this priority area. |
| 04/04/2005 |
11:19 |
PU |
150 |
E |
An
important area is the prevention of occupational fatal and non-fatal
injuries and musculoskeletal diseorders, and promotion of health in
commercial transportation workers, especially truck drivers. The public
is also affected, especially through involvement in fatal crashes
involving large trucks. |
| 04/04/2005 |
11:17 |
PU |
149 |
E |
If
this is the only place for research on injury and violence prevention -
there is not sufficient focus on this major social problem. A focus on
both community and family - level violence is of such huge importance
in terms of the health and mental health toll it takes, that only
cursory attention to it is problematic. |
| 04/04/2005 |
11:12 |
PU |
148 |
E |
This
category needs to differentiate between intentional and unintentioal
violence/injury, and needs special attention paid to gender-based
violence in ALL forms and contexts. |
| 04/03/2005 |
21:43 |
PU |
144 |
E |
E1-2
and E21. please add Meth labs to these to areas for investigation.
E7-12. please make sure alcohol and other drugs (AOD)are included in
these areas. alcohol is a major contributing factor to all the major
causes of death and injury in teens. more study needs to be done on
risk and protective factors to AOD use by children and the role all
sectors of the community can play in building up protective factors.
all programs or policies studied should have cost /benefit data
available to help communities decide on what programs are best for
them.
E13. test brief interventions in these settings for AOD use and the
reductions in other medical usage the interventions cause.
E14 - explore the connection between parenting styles and AOD use by
children.
E15 - is alcohol a common thread in all these types of violence?
E16 - do occupational injuries happen more frequently to moderate or
heavy drinkers/ drug users? what impact does the misuse of perscription
drugs have on injuries?
alcoholism is a pediatric disease with life time consequenses and a
peak age of addition of 18. it causes developmental delays and
disabilities on one end of the spectrum and death on the other and has
reach epidemic proportions in the USA.
researh the relationship of alcohol as courage booster,ie taken before
an act of violence so prepretrator will have the courage to do violent
acts.
study post traumatic stree syndrome and effects in children and adults.
what effects does seeing the same tramic scene on TV over and over
again have on people? what effect does serving in a war zone have on
the military person as well as the family? what effect does seeing
violence or experiencing violent acts have on learning and behaviors? |
| 04/01/2005 |
14:35 |
PU |
143 |
E |
The
proposed CDC's structural/organizational combining of three quite
diverse research areas ( environmental health, occupational health and
injury prevention) may offer some rationale values for potential cost
savings. However, as a seasoned injuyr control historian and student of
leadership, I am concerned also with the potential to limited a level
of effective creative ongoing injury prevention resources in such a
"consolidated" national research structure. Combining injury with the
tradtionally better funded and public supported manpower, advocacy
presence for non-injury prevention will, I predict, signifcantly
negatively affect the outstanding research in injury prevention and in
the public health's societal savings. Injury is the leading cause of
youth death and disabilty; for other age groups the potential for even
more injury evidence-based outcomes also remains substantial . A
catagorical joining of these three programs will limit the functioning
of the newest player, namely, injury prevention. Everything has a
history, even the present. And sea changes must be assessed against
that history to assure ' not to break things that may be already for
the most part fixed. When catagories are combined they should have more
similar properties than
just public health research. The question : where should injury
research be? was asked in 1956 in a national Brookings Institute
research publication report ( and that question was also responded to
in decades of professional Journals and books) .....Environmental
health and injury were part of the same national governmental
structural organizational "system," in the 1940's, for a few years (
see Fisher L. Brown T. AJPH, Voices from the Past. Aug ( or June) 2004
) . That federal reorganization placed injury into the National
Security Adminstration's human factor-environmental health focus which
for the most part ineffectively conducted national- state-local public
informational whims common to the human factors school, blaming the
victim descriptive research work of its day.... In the 1960's, under
the Bureau of Community Environmental Management, PHS's , injury
reorganization, the state of the art and focus on non-evidenced based
broad programming very much diluted much growth on effective research
and practice for injury control.... The later led to President Kennedy
intital policy that injury were a public priority and his legacy under
President Johnson removing 'injury control' to a newly established
National Bureau of Traffic Safety ( now NHTSA) and the remains into the
FDA. Afterwards, prevention of home, public and occuptional injury
control became static until the 1980's when the federal Consumer
Product Safety Commission (PL92-573)- to focus on the home cosumer
product-injury relationships- and also the Occupational Safety
Administration were created. In each generation ( see my newsletter and
members' only commentaries at www.icehs.org ) injury prevention
research has been significantly limited until the CDC's National Center
for Injury Prevention and Control was established some 15 years ago
after reports of the National Academy of Sciences, office of Medicine.
Leadership requires not only assessing data on health effects ( injury
is one of the largest, nationally ) but also various policy research
organizational -structure options and. assurances that substantial
progress in national injury prevention research will NOT be traded off
by any reorganization models . If anything, injury prevention research
must be maintained and expanded to highest leadership level in methods,
manpower and funding, and collabrations with other fields of public
health and safety. Otherwise, I see a less than meaningful Fin de
Siecle ( end of an era) for saving lives and limbs by injury research
and practice; a shared historical vision again, potentially, misplaced
. History can not predict the future, but only possible guide in what
processes and outcomes, other leadership personalities, values and
events have gone through
for the public's health and safety.
Thank you. .
Les Fisher MPH
Safety Management Consultant
97 Union Avenue, South
Delmar, NY 12054
USA
518-439-0326 |
| 04/01/2005 |
08:20 |
DC |
142 |
E |
Provide consistent guidelines for exposure to bloodborne pathogens between the CDC and state Health Departments. NYS differs. |
| 03/31/2005 |
15:55 |
DC |
134 |
E |
Please
give priority to establishing a scientifically appropriate, cost
effective method for keeping healthcare workers safe from airborne
pathogens. OSHA's assessment of risk has been based on industrial
criteria and is not appropriate in the healthcare setting. |
| 03/30/2005 |
22:35 |
OH |
133 |
E |
The
general public and people with disabling conditions in particular, will
have difficulty participating in these events if more specific
schedules are not posted. It's as though the object is to discourage
participation. |
| 03/30/2005 |
10:37 |
DC |
131 |
E |
I
would like to see more focus on air quality testing and guidelines for
hospitals,ambulatory surgery centers. See more proactive stance on
prevention of injuries and accountability for follow up on injuries
that could be prevented.
More education and resources to be used in educating and training staff
on prevention. Focus on lighting and how that affects workers and their
environments. |
| 03/29/2005 |
15:48 |
DC |
119 |
E |
I
would like to see more information regarding indoor air pollution. We
seem to have 1 unit that continues to complain about air problems. We
have investigated and searched for the resolution to this problem
without success. Is it possible that we have a unit of highly sensitive
individuals? We have checked air exchanges, mold, chemical agents etc. |
| 03/29/2005 |
10:57 |
DC |
111 |
E |
Don't
forget about secondhand smoke. It remains a significant environmental
and occupational risk factor that is not being adequately and evenly
addressed across all states. |
| 03/29/2005 |
10:42 |
DC |
107 |
E |
Job rotation to decrease repetitive motion injuries |
| 03/28/2005 |
13:29 |
DC |
102 |
E |
Autoimmune
and allergy type conditions seem to be significantly increased in our
population. Increases are evident in adult populations (working age)
but also in pediatric populations (especially school age). We question
the potential for further risk reduction. |
| 03/28/2005 |
12:40 |
DC |
90 |
E |
Would
like to see CDC get involved with a campaign to use alternative methods
to suturing lines into patients. The risk to the healthcare worker and
patient increase using old methods. Also need a campaign to stop the
practice of razor prepping patients for surgery. The data is out there
to support a change in practice. |
| 03/28/2005 |
12:25 |
WA |
85 |
E |
E4
should be retitled, "Environmental Health Outreach and Education", and
should state: "Identify, develop, and evaluate effective environmental
health messages to all audiences, using community-based participatory
research and culturally competent strategies to prevent environmental
health threats and promote health to all communities." |
| 03/28/2005 |
11:48 |
DC |
82 |
E |
Establishing
a common data base for all Environmental and Occupational Health and
Injuries to be reported into by the reporting facility is basic to
organizing this data and its analysis. Electronic reporting by
facilities or individuals would make such information easier to report.
|
| 03/28/2005 |
11:33 |
DC |
78 |
E |
Companies
that manufacture safety medical devices should be encouraged to make
these devices with less parts and easier to use. Cost should not be so
high as to discourage facilities from purchasing them. |
| 03/28/2005 |
10:14 |
DC |
69 |
E |
Do not need annual mask fit testing. Big waste of time and money. |
| 03/28/2005 |
09:35 |
PU |
66 |
E |
As
nurses comprise the largest proportion of health care providers in this
country, and as nurses impact the public health at myriad points of
care outside the acute, hospital-based system of care, I feel it
imperative that nurses be prepared to include environmental health
assessment, education, and intervention in their interactions with all
patients/citizens. To this end, I request that the CDC consider
increasing their commitment to nursing research, including studies
which examine the validity of 1) integration of environmental health
assessments into nursing practice, 2) nursing intervention to educate
citizens and communities regarding environmental health risks, and 3)
the effectiveness of nursing interventions on the overall health of the
individuals and communities.
In addition, I encourage the CDC to include nurses in any
multidisciplinary team that conducts environmental health research.
Finally, I request that environmental health research be directed at
our most vulnerable citizens…the unborn fetus, child, pregnant woman,
and aged populations. The concepts of environmental justice also
requires that minority populations come under the research spotlight in
order to develop a sophisticated knowledge and interventional plan for
those special groups generally receiving the dregs of our health care
resources.
Respectfully submitted,
Kathleen S. Morris MSA, RN
Director of Nursing Practice
Ohio Nurses Association
4000 E. Main Street
Columbus, Ohio 43213-2983
kmorris@ohnurses.org
614-448-1026
|
| 03/28/2005 |
09:17 |
DC |
65 |
E |
Prioritize
research on the relative role and effectiveness of
respiratory protection and need for fit-testing in the control of
transmission of various infectious agents, including Mycobacterium
tuberculosis.
|
| 03/28/2005 |
08:41 |
DC |
61 |
E |
1.
Prioritize research on the relative role and effectiveness of
respiratory protection and need for fit-testing in the control of
transmission of various infectious agents, including Mycobacterium
tuberculosis.
2. Outcome research (transmission studies) to define the relative
importance of the hierarchy of controls in preventing healthcare
associated transmission of Mycobacterium tuberculosis and other
infectious agents potentially transmitted via the airborne route:
administrative, environmental and personal protective equipment.
3. Health outcome and cost-benefit studies on the use of personal
protective equipment: types of respiratory protection, frequency and
utility of fit-testing.
4. The relative role of patient characteristics, procedure-related
events and environmental sources of infectious agents in airborne
disease transmission |
| 03/28/2005 |
08:10 |
DC |
59 |
E |
CDC
should definitley do as much as possible to persuade regulatory
agencies to base their policies on science (evidence based) rather than
trying to create standards which do not apply to all occupations or
risks. Obviously, the OSHA requirement for annual fit testing for
respirators in healthcare is one example. |
| 03/25/2005 |
11:30 |
DC |
49 |
E |
There
needs to be further discussion and research on the requirement to have
healthcare workers tested yearly for TB. Being a health care worker I
would prefer to be test immediately before being assigned to a patient
with TB. Changes in facial features, remembering how to apply the mask
appropriately, etc. would influence my decision to request a fit test.
I believe that yearly fit testing, especially for hospitals in rural
locations that might see 1 or 2 cases of TB in a year, is time
consuming and a waste of precious healthcare dollars. |
| 03/24/2005 |
18:44 |
WA |
45 |
E |
Housing and Health:
- Characteristics of housing that affect health status: etiologic research
- Measurement of indoor environmental exposures related to health: methodologiocal research
-Effectiveness of housing interventions for improving health: intervention research |
| 03/24/2005 |
17:47 |
WA |
44 |
E |
Testimony
for CDC Research Agenda Development Public Participation Meeting
Seattle, Washington March 24, 2005
Pamela Tazioli, Breast Cancer Fund
Good morning. My name is Pamela Tazioli and I am the Washington State
Coordinator for the Breast Cancer Fund. I am also a 4-year breast
cancer survivor.
The mission of the Breast Cancer Fund is to identify—and advocate for
the elimination of—environmental and other preventable causes of breast
cancer. We very much appreciate the opportunity to participate in this
hearing and to help shape the CDC research agenda. Breast cancer is the
most common cancer among women worldwide. During the past 50 years, the
lifetime risk of breast cancer in the United States has more than
tripled in the United States. In the 1940s, a woman’s lifetime risk of
breast cancer was 1 in 22. In 2004, it is one in 7 and rising. Breast
cancer is the leading cause of death in women ages 34 to 44. Washington
State has the highest rate of breast cancer in the United States and no
one knows why. This year, nearly 4,000 women in Washington state will
be diagnosed with breast cancer and nearly 800 women will die of breast
cancer. Each one is one too many.
Nationally this year, an estimated 211,000 women will be diagnosed with
invasive breast cancer and another 58,000 will be diagnosed with in
situ breast cancer. More than 40,000 women will die of breast cancer.
For too long, breast cancer was considered a woman’s personal tragedy.
For the past three decades, cancer research has focused increasingly on
the personal: on genetics, as though our DNA existed not in a complex
organism but in a Petri dish or under a bell jar. One author calls this
limited vision gene myopia. This gene myopia has imposed a costly
ignorance about breast cancer.
Any disease that kills 40,000 women a year is more than a personal
tragedy. It is a public health crisis—and CDC’s research agenda needs
to reflect that reality. Research efforts should be focused in areas
most likely to provide useful information for shaping public policies
that will reduce environmental exposures and protect public health. The
recommendations that follow are based on the consensus of scientists,
clinicians, advocates and community representatives attending the first
International Summit on Breast Cancer and the Environment held in May
2002. This summit was initiated by the Breast Cancer Fund, and
co-sponsored by CDC, the University of California Berkeley NIEHS Center
on Environmental Health and the International Agency for Research on
Cancer.
The types of research most likely to produce evidence useful in shaping
public policy changes will be those examining:
(1) the interplay between the timing of exposures (especially periods
of vulnerability), multiple exposures and chronic exposures (including
occupational exposures); (2) disparities in health outcomes and
differences in exposures among racial groups
(3) human contamination, measured by biomonitoring, such as the
excellent NHANES research; and (4) public health studies examining
unexplained patterns of breast cancer. Timing of Exposures
Timing of exposure is just as important as the dose of a chemical or
radiation in terms of later health effects. For example, we need
long-term studies of girls who were fed soy formula as infants. This
would help answer questions about whether early exposure to dietary
phytoestrogens affect later breast cancer risk. Multiple Exposures
All of us are exposed to hundreds, perhaps thousands, of synthetic
chemicals every day, many of which may interact. The combined activity
of the multi-chemical mixtures we are exposed to must be investigated.
Chronic Exposures
We need more occupational studies on women, who now make up nearly half
the U.S. workforce. One of the earliest studies on workplace exposures
found that more than half a million women were occupationally exposed
to ionizing radiation and that tens of thousands were exposed to
carcinogenic chemicals. Yet relatively few recent studies have been
carried out in the U.S. to identify
occupational risk factors for women.
Many women in the U.S. have two places of work: in the home and in the
paid workplace. To accurately assess environmental exposures that may
increase the risk of breast cancer, researchers need to consider
exposures at both sites, individually and collectively.
We need more research on electromagnetic fields (EMF) and breast
cancer. All of us are exposed to EMFs every day. EMFs are a type of
non-ionizing radiation and include microwaves, radio waves, radar and
power frequency radiation associated with electricity. In 2001, a
meta-analysis of 48 published research studies on the association
between EMF exposure and breast cancer found the data “consistent with
the idea that exposures to EMF, as defined, are associated with some
increase in breast cancer risks, albeit that the excess risk is small.”
The International Agency for Research on Cancer classifies EMF as a
possible human carcinogen. Despite these studies, there has been little
federally funded research in this area in the U.S. since 1998.
Disparities in Health Outcomes
Many studies are needed to explain disparities in breast cancer
incidence, mortality and environmental exposures among women of color.
For example, postmenopausal Hispanic women appear to be at
significantly greater risk of breast cancer related to estrogen
replacement therapy than non-Hispanic white women. This difference
could suggest greater sensitivity to environmental estrogens. Breast
cancer rates are rising rapidly in Asian American women, particularly
in Japanese American women. Research is needed to determine whether
environmental exposures are contributing to these differences.
Human Contamination (Biomonitoring) and Health Tracking
We need to know more about the pollution in people. For example, a
study conducted at the University of Washington found that nearly all
children in Seattle are likely to have measurable levels of
organophosphate pesticides in their urine. CDC’s own biomonitoring
research shows that our bodies have become contaminated with more than
100 synthetic chemicals. Each of us is a walking, talking toxic waste
site. Breast Cancer Fund urges CDC to expand the biomonitoring
component of the National Health and Nutrition Examination Survey
(NHANES) to measure the chemical body burden in not only blood and
urine but also in breast milk. A study of flame retardants in breast
milk showed that levels of these compounds in the milk of Pacific
Northwest women are higher than levels in breast milk from Japan,
Sweden, Canada and Texas. Monitoring breast milk reveals the
environmental contamination of our bodies and our communities and
provides a clear direction for policy changes that will protect public
health. Biomonitoring, together with diligent tracking of health
outcomes, can help explain the role of environmental toxicants in
breast cancer and other cancers. Yet health outcomes tracking is
inadequate for most chronic diseases and even in cancer. All cancer
registries should be adequately funded to cover the entire U.S. Current
U.S. cancer statistics are estimates based on data from 18 regional
sites, calculated by the National Cancer Institute’s Surveillance,
Epidemiology and End Results (SEER) Program. Theses estimates are based
on actual cancer cases in about 74 million people or about 25 percent
of the population. We also urge CDC to revamp NHANES so that
state-specific exposure information can be pulled out and used to
inform policy changes. This may not be possible for all states but for
states with large populations, it would provide data useful in shaping
public policy.
CDC’s Second National Report on Human Exposure to Environmental
Chemicals shows that public policy changes based on biomonitoring make
a difference. Body burdens of PCBs, DDT, and cotinine (the breakdown
product of nicotine) have all declined since PCBs and DDT were banned
in the U.S. and smoking controls were implemented. Precautionary public
health measures, based on information about the dangers of toxic
chemicals, can and do make a difference.
Unexplained Patterns Of Breast Cancer We urge CDC to conduct studies in
states such as Washington and Oregon which lead the nation in breast
cancer incidence. These studies should look at the relationship between
specific chemicals and breast cancer in these areas, based on point
source, ambient contamination, and human biomonitoring.
Breast cancer is a symptom of a larger cancer epidemic in America. For
the first time, cancer has surpassed heart disease as the leading cause
of death in Americans under age 85. The lifetime risk of breast cancer
is 1 in 7. The lifetime risk of some kind of cancer is 1 in 3 for women
and 1 in 2 for men. These terrible numbers are not the result of
pollution in the gene pool but the pollution of our bodies and our
communities. CDC research is essential to halting this costly onslaught
of cancer. As a woman who lives in the shadow of breast cancer, I urge
CDC to focus research on cancer and chronic diseases as a public health
issue.
Ten U.S. states with highest incidence of breast cancer Washington 148
Oregon 145
Massachusetts 143
Connecticut 143
District of Columbia 143
Alaska 139
Minnesota 138
New Jersey 138
New Hampshire 135
Wisconsin 135
_____________________________________________________________
Pamela Tazioli
Washington State Coordinator
Breast Cancer Fund
Pamela@breastcancerfund.org
www.breastcancerfund.org
|
| 03/24/2005 |
12:15 |
DC |
43 |
E |
Severe
injuries take an important but unmeasured toll on family members. These
“secondary” impacts of severe injuries, such as depression, suicide,
post-traumatic stress, divorce, family violence, on family members are
not well documented. The loss or disability of a spouse, the
breadwinner, siblings or children, all have different social dynamics
associated with such events. However, we know little about how to
quantify, predict or prevent these secondary impacts. In many areas,
especially child abuse and domestic violence, important strides have
been made in increasing the visibility of the role of acute care
providers in identification and referral. However, most studies have
shown a large fall off in compliance over time. Efforts to understand
what factors lead to long term success of these programs in the acute
care setting are needed.
From the ages of 10-44 poisonings are the leading cause of injury
hospitalization in women. This is a tremendously understudied public
health burden that appears to be derived from mostly intentional
behavior. While analgesic and tranquilizer agents predominate, little
is known about risk factors, long term impacts, costs, or effective
preventive measures.
|
| 03/24/2005 |
11:51 |
OH |
42 |
E |
I
would like to comment on theme ID# H3, Health Birth Outcomes. In
general I strongly support this research theme. What is missing however
is implicit inclusion of injuries and violence among the types of
maternal exposures that may lead to adverse birth outcomes and the need
to specifically acknowledge trauma as more of a priority for maternal
exposure prevention. Although violence during pregnancy has received
some attention (I commend CDC for the 1997 publication on “Key
Scientific Issues for Research on Violence Occurring Around the Time of
Pregnancy”), research has shown that unintentional injuries are an even
greater burden during pregnancy. However, they are not mentioned in the
Research Agenda for Injury Prevention priorities nor have they received
much attention from the Reproductive Health Branch. Recent linkages
between ED visits and birth records in one state showed that about 4%
of all pregnancies involved an ED injury visit during the pregnancy.
Among leading mechanisms, motor vehicle occupant injuries accounted for
(22%), falls (17%), cutting and piercing (10%), struck by/against
(10%), overexertion (8%), and poisonings (3%). Among the injuries with
known intent, 92% were unintentional, 7% assaults, and 1%
self-inflicted. This translates to over 160,000 ED level injury
exposures per year with little follow-up if the impact on the baby.
Schiff & Holt recently reported large relative risks for placental
abruption among women hospitalized for severe, non-severe and minor
motor vehicle injury (9.0, 4.8, 6.6, respectively) [Pregnancy Outcomes
following Hospitalization for Motor Vehicle Crashes in Washington State
from 1989 to 2001. Am J Epidemiol, 161(6), 503-10, 2005]. Yet little
work focuses on expanding primary prevention programs for these events.
It is an area that needs its own research agenda and needs to be
included in both the Health Promotion and Injury Prevention Workgroup
research priorities. Currently this area of research need is claimed by
no CDC Coordinating Center. It needs to be claimed by both in a
coordinative fashion.
Cordially, Hank Weiss MPH, PhD Director and Associate Professor Center
for Injury Research and Control University of Pittsburgh Building/Room:
Scaife 532D
Mail: 200 Lothrop St., Suite B-400 Pittsburgh, PA 15213
hw@injurycontrol.com or weisshb@upmc.edu
Phone: 412/648-9290 Fax: 412/648-8924
|
| 03/23/2005 |
17:48 |
WA |
40 |
E |
Several
comments regarding occupational health:
1. With very few exceptions, there is little state and local public
health infrastructure centered on occupational safety and health.
Unlike injury prevention and environmental health surveillance data is
poor and the capacity for prevention and intervention outside of a
regulatory framework does not exist at the state and local level. Fewer
than 15 states receive federal money for surveillance programs and the
states that do are very poorly funded.
The rationale for occupational health investment is clear; workers
spend approx 1/3 of their lives at work; occupational injuries and
illnesses are expensive and cause signficant disability. Relatively few
individuals have meaningful training in occupational epidemiology,
occupational medicine. occupational safety and other occupational
health specialties. Investments in occupational health are not
exclusive of impacts on other important areas of public health. A
component of emergency preparedness for natural disasters, and events
related to terrorism would be wisely spent with an emphasis at
workplace preparedness. Dedicated funding within state departments of
health/labor may facilitate employer preparedness. Occupational injury
programs and research are sparse and lack depth and resources. Injury
prevention research funding traditionally has not integrated
occupational injury prevention. |
| 03/21/2005 |
12:19 |
WA |
36 |
E |
Good
afternoon,
It is essential that the CDC enhance funding and broaden the research
agenda to include translational research projects that explore the
impact of environmental health assessments and risk reduction measures
conducted by nurses out in the community. In Wisconsin, we have been
actively involved with a number of projects to reduce the health
effects of environmental expsosures through our community nursing
centers which provide primary health care, as well as community based
health promotion and disease prevention programs. One example are the
mercury hair screening programs conducted in conjunction with the
Wisconsin State Health Department, as part of the Nationwide Health
Tracking initiative. We have tested over 125 persons in the last 9
months and held numerous health education sessions related to the
health effects of mercury toxicity. In addition, we are planning to
submit a research grant in the next year to translate recommendations
for environmental health assessment within the primary care setting.
These clinics are managed and care is provided by nurses. The public's
health (particularly of vulnerable populations) will be vastly improved
should nurses increase the capacity to conduct funded research projects
that embrace applied and translational designs in the community
setting. Sincerely,
Laura Anderko RN PhD
Associate Dean for Practice and Associate Professor
University of Wisconsin- Milwaukee
414 229-2313
landerko@uwm.edu |
| 03/21/2005 |
08:58 |
WA |
35 |
E |
A.
Intervention studies to determine the effectiveness/validity of:
1)Integration of individual and community-wide environmental health
assessments into nursing practice
2)Nursing intervention to educate individuals and communities about
environmental health risks
3)Nursing intervention to reduce individual's and community's
environmental health risks
B. Community-based participatory research as a mode of research whereby
community members co-direct all aspects of the research
C. Encouragement of multidisciplinary approaches to assessment,
intervention, evaluation research in which clinical, advanced practice,
and community/public health nurses are involved in the research teams.
D. Research to understand the environmental health risks posed by
multiple exposures, as well as the risks posed in our most vulnerable
populations - children, the frail elderly, and pregnant women.
E. Research regarding intervention to improve Indoor Air Quality (IAQ)
in schools.
|
| 03/18/2005 |
13:14 |
WA |
34 |
E |
To
make progress in reducing risks to vulnerable groups, we need a
research agenda that balances basic research with applied and
translational research. Public health (PHNs) and occupational /
environmental health nurses (OEHNs) are the primary contact point for
many families in need of health services. Nurses are the main health
care providers in: 1) worksite settings and 2) local public health
departments. There can be significant "value added" when nurses
incorporate occupational and environmental health interventions (e.g.,
risk reduction messages, safe product selection and disposal) into
their daily nursing activities. However, CDC resources to develop and
test nursing research have been very modest and not at a level to
conduct RCT studies. CDC's efforts to date to improve nursing capacity
in occupational and environmental health have been commendable. However
a larger commitment will be needed to test interventions addressing
salient topics (e.g., rural methampetamine use, household hazards,
cottage industries) and groups (e.g., low-income, minority, and
communities of elders). It is not sufficient to commit modest resources
to nursing, while allocating the lion's share of resources to other
groups. CDC would be well served by an RFA that specifically aims to
test the effectiveness of nursing occupational and environmental
interventions with homes and communities. The public's health will be
well served when nurses have both the will (which they already do), the
science (which is needed), and the capacity to integrate science-based
occ and env health messages into daily nursing activities. Thank you
for the opportunity to comment. Thank you for holding these hearings
and public participation meetings. |
| 03/17/2005 |
16:42 |
WA |
33 |
E |
I
work in the state of Washington for Public Health – Seattle & King
County as the team lead in our Illegal Drug Lab Program. We have been
dealing with the contamination caused by illegal drug manufacturing,
primarily methamphetamine, since the late 1980’s. More recently this
has become a nationwide problem. There is a great need to have
information regarding the effectiveness of decontamination processes
and how to accurately determine when it is safe to reoccupy a
structure. Questions include:
How many samples are necessary to determine that the contamination
level in a structure has been reduced to an established limit? Is it
possible to decontaminate a furnace and ductwork or do they need to be
removed from a structure because they can recontaminate a structure?
How might the level of contamination change once people reoccupy a
structure? (i.e. Will contaminants that were imbedded in the drywall or
encapsulated in paint come to the surface as heat, air flow and
activity in the structure resume?) How effective are various cleaning
compounds and methods ? Do any of the cleaners, such as oxidizers,
create a problem by chemically changing methamphetamine or by-products
into something perhaps even more harmful but since methamphetamine is
used as the indicator, goes undetected? And of course there is the very
difficult question, what level of decontamination is needed to protect
public health?
Terry Clements
Illegal Drug Lab Program
Public Health – Seattle & King County
206-296-3993
fax 206-296-0189
|
| 03/17/2005 |
11:07 |
WA |
32 |
E |
. |
| 03/15/2005 |
17:15 |
WA |
30 |
E |
There
is a lack of research focused on prevenetion strategies in relation to
intentional injury. There shoudl be an emphasis on research focused on
sexual violence pimary victim preventions and sexual violence primary
perpetrator prevention. This will enable us to define best practice as
we move forward. The majority of research focused on the issue of
sexual violence has been prevalance and incidence studies as well as
evaluation of current intervention/treatment strategies. Although this
data has been extremely important in the fight to end sexual violence,
this data has limited applications in relation to the development of
effective prevention strategies |
| 03/15/2005 |
14:12 |
WA |
28 |
E |
I
hope that environmental justice can be a part of the agenda.
Specifically, there is a need to collect data and conduct scientific
research to more specifically identify the human health and
environmental risks created by multiple exposures to contamination in
low income and minority communities. Many non EJ researchers have
stated that the statistical power to meanifully study these populations
in not available. |
| 03/11/2005 |
15:59 |
WA |
19 |
E |
Research for development of remediation standards and guidelines for methamphetamine drug lab sites. |
| 03/08/2005 |
14:27 |
OH |
13 |
E |
Injury
is consistently the # cause of death among all ages in the US yet it
receives a fraction of the funding directed toward infectious and
chronic disease. |
| 03/04/2005 |
14:59 |
DC |
11 |
E |
The
CDC is leading the way in measuring chemicals in the human body.
However, for most of the chemicals in its National Exposure Reports, it
has left to others the task of interpreting the data. We think the CDC
should devote more efforts to develop the tools needed to interpret
biomonitoring data to enable the CDC, the public, and policy makers to
better understand and distinguish those exposures which are of little
or no consequence to health from those that may pose some degree of
potential health risk. We think it is important for the CDC to consider
devoting some research program resources aimed at developing the
necessary methods to interpret human biomonitoring concentrations in
the context of potential health risks. |
| 03/02/2005 |
11:19 |
OH |
8 |
E |
I do hope this area will include issues concerning workplace violence, psychological aggression, and bullying. |
Back
to Top
|
| Date |
Time |
Type |
ID |
Group |
Comment
|
| 04/19/2005 |
21:38 |
PU |
468 |
G |
The
G17 examples will need some development, for example working on
prevention of preterm birth and developing strategies to prevent
neonatal infections. Overall this looks pretty good. With vaccination,
CDC has a clear role in helping countries set up surveillance for
vaccine-preventable diseases to enable policy-makers to determine if
they should adopt a vaccine and then, once a vaccine is adopted, to
help them determine the vaccine's effect on disease. |
| 04/19/2005 |
17:26 |
PU |
463 |
G |
Does
social capital include poverty? Poverty is a key cause of healht
problems, and the relationship between poverty and health should be
examined and addressed. Community-based participatory research should
be thematic here. Attention should be paid to careful development and
evaluation of the *processes* by which we work towards global health
goals-- goals which involve complex systems, multiple cultures, and
widespread geographic areas. |
| 04/19/2005 |
16:57 |
PU |
460 |
G |
make
it clear that global health problems include the US--women and
children, exploitation and abuse, reproductive health, HIV, etc. |
| 04/19/2005 |
16:13 |
PU |
457 |
G |
Currently
much of CDC's research is limited to cooperative agreements available
to members of three organizations: Association of American Medical
Colleges (AAMA), Association of Schools of Public Health (ASPH) and the
Association of Teachers of Preventive Medicine (ATPM). There are
respectable and qualified researchers in state and private universities
who do not have a medical school or a school of public health
associated with the university. The CDC reseach agenda should be open
to competition to established researchers who are not members of these
three organizations that are the receipients of umbrella cooperative
agreements. |
| 04/19/2005 |
15:54 |
PU |
455 |
G |
Consider
research theme relating to Consequences of the AIDS epidemic on
diminished provision of Public Health services to the population.
Explanation: The AIDS epidemic in Africa and elsewhere
disproportionately effects the most economically productive members of
society, including public health workers. What is the impact on public
health programs (immunizations, maternal child health, Tb, etc.) beyond
the burden of AIDS and AIDS-related diseases themselves)? |
| 04/19/2005 |
15:31 |
PU |
452 |
G |
G1 is not specific to global health research.
Many examples are not research activities. |
| 04/19/2005 |
14:46 |
PU |
449 |
G |
I
would like to propose a new research theme: “Strengthening health
systems.” The description is: “Develop and evaluate strategies to
strengthen health systems, with an emphasis on improving health
workers’ adherence to clinical guidelines.” Examples of research
activities include: 1) Develop an empirically-based theory that
explains health worker practices, 2) Evaluate the cost and
effectiveness of interventions to improve health worker performance,
and 3) Develop and test strategies to scale-up interventions to improve
health worker performance and integrate the interventions into national
health systems. The justification is that numerous efficacious
technologies (antimicrobials, malaria bednets, etc) exist that can
prevent many deaths in developing countries; and a key barrier to
preventing such deaths is that health workers in hospitals, clinics,
and villages often to do not adhere to clinical guidelines that
recommend use of these technologies. Inadequate health worker
performance is an enormous public health problem that directly impacts
health status and affects nearly every geographical area and health
field. In fact, this topic is linked to numerous other Global Health
Research Themes (e.g., G5, G9, G12, G13, G14, and G17). Furthermore,
health systems are weakest in areas with the poorest populations,
therefore research aimed at developing practical solutions for such
areas are likely to reduce the large imbalance between the quality of
care for poorer and wealthier patients. |
| 04/19/2005 |
14:20 |
PU |
446 |
G |
G1
– Educational impact to prevent binge drinking and alcohol use should
be included in research.
G2 – Improvement in the determination of causes death, i.e., those that
are attributable to certain risk factors such as binge drinking and
heavy alcohol use.
G4 – Improve global alcohol surveillance capacity by working with local
governments and World Health Organization
G13 – Include the study of risk factors that increase the risk of HIV
transmission such as binge drinking and sexual assault
|
| 04/19/2005 |
08:30 |
PU |
420 |
G |
The relationship of global biopsychosocial challenges to the next wave of terrorism.
The significance of effective family planning and prevention programs in global stability. |
| 04/18/2005 |
13:47 |
PU |
402 |
G |
Many
of these themes would seem to fit logically in other Research Priority
areas - Infectious Diseases, Injury Prevention, Health Marketing, etc. |
| 04/18/2005 |
12:19 |
PU |
393 |
G |
1.
Curbing Global Population Growth is a critical issue for CDC and all
health agencies around the world, yet it does not appear on the Starter
List of Global Health Research. It is critical that this topic be added
to the list, and that family planning be an integral part of activities
geared towards slowing down the rate of population growth. 2. As
chronic diseases become more prevalent around the globe, it is critical
that increasing attention and resources be directed towards preventing
the conditions which promote chronic disease. |
| 04/18/2005 |
11:15 |
PU |
389 |
G |
Support research-based practices to optimize child birth and developmental outcomes, in the United States and in the world. |
| 04/18/2005 |
10:21 |
PU |
388 |
G |
I
feel that we need to assist with the developmental disability issue
globally. Many underdeveloped countries allow children with autism or
developmental delay to go untouched and untreated. |
| 04/18/2005 |
08:23 |
PU |
380 |
G |
Global
Health is going to become magnified in the coming future. As CDC
directs its focus on health/prevention here at home, our next challenge
will come from abroad and most importantly from the developing nations.
I see in the CDC's plan of reorganization Global Health is one of the
strategic imperative, but I am a little disappointed that they did not
include the wording "DISEASE PREVENTION" which is by the way a part of
our name as well as what we do in other nations. We try to prevent
diseases from spreading, for example: Polio vaccination, safe water
project in Asia and so on...perhaps we should try more ties with local
NGO’s to have a greater impact. Spreading our knowledge and reaching
those remote areas of the world will give us the best results in
disease control and prevention. Yes we do need research and we can do a
lot more being active in the fields (more health hygiene educators to
talk to people). There are a lot of people at CDC with country specific
knowledge in culture, way things are done, language etc. that can help.
Participation should be encourage. Thank you! |
| 04/18/2005 |
06:24 |
PU |
374 |
G |
Good that you include evaluation of quality and consider standards. |
| 04/15/2005 |
15:30 |
PU |
365 |
G |
Will
there be any items on human resource development (empowerment, and
self-sustainability-even though this would be a long long range item)
in developing nations. |
| 04/15/2005 |
14:13 |
PU |
361 |
G |
The
greatest contribution CDC could make to the safety and health of the
public is to begin a dialogue on the delivery of health care in our
communities in a non-partisan, non-ideological, open discussion.
Promote objective reviews and educational forums to educate the public
on both the short-comings and the advantages of our current approach to
health care delivery. Leave no stones unturned. Review the AMA, the
health insurance companies, our legal system, the educational system,
and federal funding. Present alternative approaches that other
countries have employed to avoid our deficiencies and report
objectively their failures and successes. If the American public had
the objective information they need to evaluate our health care system,
we would not have the system we now have and millions of lives would be
saved annually. This is an annual loss greater than any plaque or war
our country has endured. This could be the number one accomplishment of
CDC in this century. |
| 04/15/2005 |
09:54 |
PU |
352 |
G |
Teach the approprate people of the diseases that are not normally seen in the USA |
| 04/15/2005 |
09:54 |
PU |
351 |
G |
Teach the approprate people of the diseases that are not normally seen in the USA |
| 04/15/2005 |
07:16 |
PU |
345 |
G |
HIV/AIDS
is currently listed 13th on the priority list. Given the global impact
and magnitude, the CDC priority for this disease in global health
research is very much under emphasized. Also the treat of influenza,
the importance of TB/malaria are under emphasized in these priorities. |
| 04/14/2005 |
15:48 |
PU |
339 |
G |
Is there a means to prioritize needs across geographic areas and encourage replication? |
| 04/14/2005 |
14:18 |
PU |
337 |
G |
Where
is surveillance? As one of the Trailblazers is influenza and recent
outbreaks of SARS and other emerging infections, it is amazing that
surveillance is left off. This should be listed much more
prominently!!! Hello!!? |
| 04/14/2005 |
13:49 |
PU |
333 |
G |
I
was pleased to see a focus here on injury prevention, as well as the
need for improved data globally. However, I was very sorry not to see a
specific item included under the maternal mortality goal about access
to contraception and increasing rates of contraceptive use. Obviously,
access to contraception and other aspects of healthy sexuality are
critical to imrpoving maternal health and reducing maternal mortality.
I would strongly recommend including an item on contraception and
reducing unintended pregnancy. |
| 04/14/2005 |
13:26 |
PU |
332 |
G |
Operations
research on global immunization issues, along with approaches to
assessing health burden of vaccine-preventable diseases, is very
important. |
| 04/14/2005 |
13:22 |
PU |
331 |
G |
LIke evaluatIion of cost effectiveness on stategies. |
| 04/14/2005 |
10:35 |
PU |
309 |
G |
The
list includes some treasures of CDC such as an interest to coordination
of surveillance methodology (stdization of health data) etc. However,
when it moves to topic areas it looks just like donor funding in a
typical resource poor country-unqeual distribution of interests. Rahter
than what CDC should be doing given the distribution of disease burden
or country needs, the list appears to be more of what selected programs
are doing given how they have managed to navigate funding, generate an
interest, or benefitted from some global events. This list would have
benefited from a closer look at the 2002 World Health Report, which
highlights leading public health issues in countries in various stages
of development. For instance, micronutrient malnutrition, is
highlighted but howabout nutrition in general? Alcohol is #1 cause of
disability in medium developed countries and action is needed in this
area. Emerging lifestyle and impact of globalization such as obesity,
low fruit vegetable intake, tobacco, alcohol etc are among the top
10-15 causes of illhealth in developing countries. If leading
infectious diseases are listed, why not address other leading issues.
The list reflects lack of a child health lobby at CDC (OVC is mentioned
but that emanates from the HIV interest group). For instance, child
health cohort development is a useful investment for medium developed
countires, at least one in each continent, similar to the emerging
diseases centers. If DHS have been successful with USG investments, so
would such initiatives. No mention of cancers, though cancer burden is
expected to triple by 2015 (probably reflects lack of a global cancer
work group at CDC?). In short the list may not be compatible with the
epidemiologic and risk transition that is occuring across the world,
rather an expanded wish list list of existing CDC programs, or who
participated in the planning. |
| 04/14/2005 |
10:31 |
PU |
308 |
G |
Health
Services Research area related to what are the determinants are of
governmental investment in public health is needed. We are active in
many areas where local health care is still facing basic challenges in
availablility of water and electricity, let alone surveillance systems
and response capacity. Without the basic infrastructure, including
communication, general recommendations for imporving reporting and
integrated surveillance are challenging at the least. Laboratory
capacity for example, depends on clean water and electricity.
Surveillance depends on communication systems working. We can afford
not separate these issues in development work? Hospital acquired
infections are an area that may deserve a special mention, as there
presence in many countries are inhibiting helath-care seeking behaviors? |
| 04/14/2005 |
10:30 |
PU |
307 |
G |
It
is wonderful to see women and chilren's issue highlighted by CDC. We
are no longer looking away from the white elephant. However, in order
for us to be effective we will need more than the traditional data
collection, we will have to start looking at the roots of the social
injustice, and violence against women and children. The mental health
approach should focus on prevention and identifying causes and
interventions both for men and women to prevent violence. Are we going
to be brave enough to challenge media, policies, and otehr factors
contributing to these disparities. |
| 04/14/2005 |
10:14 |
PU |
304 |
G |
This
list is ambitious but should include an agenda for tobacco which is
projected to become the single biggest cause of death world wide in the
next 3 decades. |
| 04/14/2005 |
10:09 |
PU |
302 |
G |
G8 MUST include FOLIC ACID |
| 04/14/2005 |
09:45 |
PU |
300 |
G |
With diabetes growing, focus on related growth of severe vision problems. |
| 04/13/2005 |
19:50 |
PU |
294 |
G |
Much
more needs to be done in the area of the patient-doctor relationship to
promote changes in behavior, improved communications, and improved
outcomes. Advanced patient involvement results in greater awareness, a
feeling of control, and confidence in the health care system. My book,
The Art of Being a Patient (Taming Medicine- an Insider's Guide) has
resulted in new research by Case Western Reserve University and the
Esther Lewis Warburton Foundation demonstrating the value of improved
patient understanding and compliance in reducing health care costs.
There is a tremendous need to look more closely at this area to help
rein in double digit health care inflation partially related to
unprepared and unfocused patients. I'm an expert in preventive medicine
and in promoting patient compliance and follow through.
Philip Caravella, MD, FAAFP
The Cleveland Clinic Foundation
caravep@ccf.com |
| 04/13/2005 |
16:06 |
PU |
288 |
G |
G2
Research Theme is very ambitious. Global data standards will require
compliance all the way down to the local level. I do not believe this
message has transcended throughout the CDC CIOs even. |
| 04/13/2005 |
10:37 |
PU |
273 |
G |
HIV/AIDS
epi and behavioral risk-reduction research, particularly for currently
underserved populations such as men who have sex with men |
| 04/13/2005 |
09:59 |
PU |
271 |
G |
In
this age of new pneumococcal/streptococcal vaccines (both newly
licensed and in the pipeline)
It is imperative that we continue to monitor pneumococcal and group A
streptococcal serotype and strain distribution on a global level. It is
also imperative that we continue to provide our internationally
recognized pneumococcal/streptococcal reference lab expertise. |
| 04/12/2005 |
14:51 |
PU |
264 |
G |
•
Global Health Research: Please consider the priority actions developed
by the Oral Health Program at the World Health Organization:
http://www.who.int/oral_health/action/en/ and Research for Oral Health
http://www.who.int/oral_health/action/information/surveillance/en/index2.html
|
| 04/12/2005 |
10:30 |
PU |
261 |
G |
What
role do the people from "around the world" play in shaping the policies
and research agenda set by the US? How are "they" contributing to
decision making on "what", "how", "when", and "where" things need to
happen? |
| 04/11/2005 |
22:17 |
PU |
260 |
G |
Collaborative
research in environmental and occupational diseases and injuries can
provide important information for risk assessment in the USA, as well
as assist the partner from the developing world. |
| 04/11/2005 |
09:59 |
OH |
251 |
G |
see general discussion comment below |
| 04/09/2005 |
18:43 |
PU |
237 |
G |
A
very important area that CDC has overlooked concernss the issue of
global workforce capacity and policy issues - especially with regard to
the developing world. Most recently the issue of workforce equity has
been raised by WHO (and other international associations) through
various WHA resolutions. The recruitment of health care providers, most
notably nurses from Africa and the Carribean to the UK and US, is
having a significantly negative and deleterious impact in key regions
of the world. CDC needs to capable of providing sound techincal
assistance in this area -i.e., information systems to track and account
for a scare health care workforce. Without this system in place and
without strategic planning, million of dollars will be wasted on
promoting and introducing interventions for which there is no workforce
to implement. |
| 04/08/2005 |
08:45 |
PU |
232 |
G |
I
would like to see a particular focus on the importance of access to
'reproductive control technologies' in improving the lives of women and
their families, including an awareness of these issues in interaction
with other issues such as domestic violence and HIV transmission. This
contextualized, interactional understanding is essential! |
| 04/08/2005 |
07:30 |
PU |
229 |
G |
Need
to utilize CDC resources (NCHS and NCCDPHP-DOH to more actively
participate (if not co-lead) in the development of international
standards for assessing oral diseases and conditions, evaluations of
programs that promote oral health, development of new preventive
measures to prevent oral diseases and promote oral health. CDC should
consider the establishment of a CDC international dental epidemiology
officer position (NIH/NIDCR has an international dental officer
position) to help facilitate communication between CDC and
international chief dental officers and others. NCHS could greatly
benefit from such a position. CDC should consider a temporary
assignment of an international dental officer to the WHO or to the
European Union's CDC-like institution. |
| 04/07/2005 |
19:03 |
PU |
227 |
G |
An
additional topic for research should include the effects of the trade
agreements(particularly NAFTA) on rates of motor vehcile related
injuries, there was some concern regarding the potentilal effects of
unsafe motor vehicles as a result of increased access to US roads by
trucks bringing in produce and other products from Mexico and other
Latin American Countries.. |
| 04/07/2005 |
15:59 |
PU |
224 |
G |
G.13
- Include assessment of the standardization of baseline public health
infrastructure for effective HIV/TB prevention in developing countries,
operational and infrastructure parameters. Analysis of the links
between systems and intervention programs. |
| 04/07/2005 |
11:47 |
PU |
215 |
G |
There
is lack of training in Epidemiology in India. There was one course
offered recently by ATSDR/DHS but there is need for several
Environmental Epidemiology Courses/ training in India. |
| 04/07/2005 |
10:20 |
PU |
210 |
G |
I
strongly encourage consideration of research on the US-Mexico Border.
If the Border region is considered a separate entity, it has a greater
incidence and prevalence of disease than individual states in both
countries. The transmission of disease across the Border is also
significant. |
| 04/07/2005 |
09:19 |
PU |
201 |
G |
We
have to develop important vaccines with Asian and African countries to
contain diseases, and have the vaccines avialable for the first and
second world countries. |
| 04/07/2005 |
06:45 |
PU |
190 |
G |
Also very important. Prevention of disease world wide will decrease disease at home. |
| 04/06/2005 |
17:47 |
PU |
187 |
G |
G17:
Develop community interventions which ensure appropriate reproductive
health services for families.
Assess strategies designed to prevent major causes of maternal
mortality.
Evaluate and identify surveillance methodologies for maternal,
perinatal, and child health.
Another Topic: Information, Communication and Technology. Develop,
implement, and evaluate effective uses of information, communication,
and technology in global health research
1. Define the ICT conceptual model for health promotion and prevention
of disease, injury and disability.
2. Identify challenges which can affect ICT development
3. Identify successful implementation models for sustainability.
4. Identify Toolkits for dissemination and use.
2. |
| 04/05/2005 |
15:05 |
PU |
170 |
G |
There
is a significant need for research at the international evel on the
epidemiology of child maltreatment and the CDC could provide leadership
in this area. |
| 04/05/2005 |
11:11 |
PU |
159 |
G |
This
area of research is a top priority and is directly tied to #5 Health
Promotion. I am very much interested in addressing the incidence of
childhood obesity and increasing onset of Type 2 diabetes mellitus in
children. As a fellow in pediatric psychology I see this area spreading
into EVERY case I see and would very much like to participate in
ongoing research and intervention. How can I get involved? |
| 04/04/2005 |
13:30 |
PU |
156 |
G |
Take
care of the USA. We still have too many unsolved problems. It is
recognized that many of the problems infiltrate into the USA. |
| 04/04/2005 |
11:05 |
PU |
147 |
G |
Please consider the social and cultural aspects of disease, especially in other countries. |
| 04/03/2005 |
21:43 |
PU |
144 |
G |
alcohol is very much a global disease that triggers other diseases,
disabilities, injuries and death.
G13. research the relationship between marketing by US companies and
increase use of addictive substances and the subsequent deteriation of
health and increase in STD/HIV/AIDS, TB, and chronic diseases. i like
the emphasis on cost effectiveness and developing marketing messages
that might counter act those that encourage risky behaviors.
G14. be sure to look at alcohol as a major risk factor
G17. alcohol is now being linked to stillbirth, SIDS and FASD. please
do forget to study it when you look at maternal and under 5 mortality.
|
| 04/01/2005 |
08:20 |
DC |
142 |
G |
Most difficult and valuable. Air travel should be a large part. |
| 03/30/2005 |
10:37 |
DC |
131 |
G |
Formal conferences or lectures to bring topic to light in rural communities. |
| 03/29/2005 |
10:57 |
DC |
114 |
G |
Research
needs to be performed on diseases that are now being transmitted
between species around the world, i.e. avium flu. It seems imperative
that we look at how to develop vaccines etc. to prevent the spread of
disease between species. |
| 03/28/2005 |
13:29 |
DC |
102 |
G |
Concerned
about exposure to contagious and other hazardous materials: for our
military, religious/other civilian groups providing support services in
many countries, and for the people living in countries where the USA is
involved in industry and military activities. |
| 03/28/2005 |
11:48 |
DC |
82 |
G |
Explore methods to expand the work of WHO and simplify data collection with regard to activities. |
| 03/28/2005 |
10:27 |
DC |
72 |
G |
use
of engineering controls on mass public transportation methods (i.e. air
exchanges and air filtration units on airlines or water storage and
purification on airplanes or ships) |
| 03/15/2005 |
14:12 |
WA |
28 |
G |
Chronic
diseases (tobacco, obesity) are causing morbidity and mortality
problems equaling infectious diseases and a new health paradigm/s
should be examined. |
| 03/15/2005 |
00:18 |
WA |
25 |
G |
As
mentioned above, focus on infectious disease outbreak control on a
global scale, and also vaccine distribution (cost, new development,
supply, etc.) |
| 02/25/2005 |
08:43 |
GA |
7 |
G |
Promoting directly observed therapy for TB control in developing countries.
Partnering with the private medical sector to promote standard treatment guidelines for TB treatment
TB Screening of immigrants, refugees, coming to the U.S.
Partnering with WHO for improved TB reporting and surveillance
|
Back
to Top
|
| Date |
Time |
Type |
ID |
Group |
Comment
|
| 04/19/2005 |
17:33 |
PU |
464 |
S |
Theme ID# S4
* Apply prediction algorithms.
Description Additon:
Apply recent developments, determine accuracy and identify refinements.
zbq5@cdc.gov |
| 04/19/2005 |
17:26 |
PU |
463 |
S |
Important
goal: comprehensive integration of health information services and
systems, both inside and outside the agency. Data collection and data
mining should be considered together-- data are collected for specific
purposes/questions, which limits the effectiveness of using the same
data for other purposes. It's important to recognize and anticipate
these limits, both when developing data collection plans, and
developing a data mining project. Information dissemination is also
very important-- as much of our data and information as possible should
be made accessible to folks inside and outside the agency-- it belongs
to the American people, not the staff of CDC--or, moreover, its
contractors, who often have motivation to keep data to themselves, at
least for awhile, and to the detriment often of the purposes for which
the project was initiated. |
| 04/19/2005 |
16:59 |
PU |
462 |
S |
Please,
please, PLEASE don't ignore the workplace! For S12 in particular,
workplace needs to be added to the listing of care/information delivery
settings. The quality of information workers receive about hazards on
the job is abysmal in many cases, and CDC/NIOSH has a distinct role to
play in this setting.
[comment from Barb Grajewski, NIOSH] |
| 04/19/2005 |
16:13 |
PU |
457 |
S |
Currently
much of CDC's research is limited to cooperative agreements available
to members of three organizations: Association of American Medical
Colleges (AAMA), Association of Schools of Public Health (ASPH) and the
Association of Teachers of Preventive Medicine (ATPM). There are
respectable and qualified researchers in state and private universities
who do not have a medical school or a school of public health
associated with the university. The CDC reseach agenda should be open
to competition to established researchers who are not members of these
three organizations that are the receipients of umbrella cooperative
agreements. |
| 04/19/2005 |
15:31 |
PU |
452 |
S |
Again, many examples are not research activities. |
| 04/19/2005 |
10:29 |
PU |
425 |
S |
Suggest
inclusion of rural and frontier areas, especially in regard to
syndromic surveillance focused on emerging infectious disease threats. |
| 04/19/2005 |
10:29 |
PU |
424 |
S |
I
would like to see real effort and foresight used to design appropriate
IT resources and support, including choosing IT leads who actually
consider the users (and not just their own career development) when
developing systems. CDC is way, way behind in IT development. This
hampers the success and efficiency of our surveillance systems. |
| 04/19/2005 |
10:23 |
PU |
423 |
S |
Themes
S.12, S.13, and S.17 seem to assume that messages generated by CDC are
sufficient to change behavior. I recommend that the research activities
for S.13 include: Develop messages to inform and direct persons to
supportive and skills-building resources.
I recommend that the research activities for S.12 and S.17 include:
Identify risk/benefit perceptions and barriers to behavior change for
population segments in order to develop salient messages.
I recommend that the research activities for S.16 include: Create and
improve health literacy and communication skills among health
professionals and health communicators so they can explain
health-related matters using easy-to-understand terms and examples. |
| 04/19/2005 |
06:48 |
PU |
417 |
S |
Theme
ID # S19 Research theme title and description
Partnerships as Health Marketing Channels Investigate how prevention
and health protection messages can be more effectively delivered
through private-public partnerships
Examples of research activities
• Develop methods of quantitative evaluation of the effects of
partnerships on public health outcomes
• Develop tools and guidelines that will enhance partners’ ability to
affect public health outcomes
• Compile profiles of prevention partners by sector (medical care,
employers, educational institutions, other government agencies) •
Develop typology of private-public partnership arrangements and
investigate their effects on health outcomes
• Analyze variations in delivery of preventive services across sector
partners, develop and test sector-specific strategies for targeted
delivery of prevention messages |
| 04/18/2005 |
16:26 |
PU |
414 |
S |
CDC
support for evaluation (qualitative analysis) software & analysis.
Qualitative Analysis workgroups around program evaluation activities in
states. (this may be more applicable under Cross-Cutting Research: not
sure) |
| 04/18/2005 |
14:02 |
PU |
403 |
S |
Including
Theme ID# 1, 2, 4, 5, 6, 7, 8, & 9 in the Health Information
Services Research seems to be more directly relevant for the
cross-cutting research area than this area. It more directly supports
the p.h. science than information services. These areas are really the
core sciences necessary for analysis & interpretation of data to
support cross-cutting p.h. research. |
| 04/18/2005 |
13:47 |
PU |
402 |
S |
Other
than trying to fix everything related to Health Information Services,
the main ideas put forth are solid, and just need to be focused on
prioritieis. |
| 04/18/2005 |
11:15 |
PU |
389 |
S |
Identify
other sources of important public health information, such as
educational records and standardize agreements for public health access
and use of these data. |
| 04/18/2005 |
09:15 |
PU |
383 |
S |
Research/pilot
projects regarding interconnection of large health information systems
(e.g. EMRs, immunization registries, disease surveillance systems,
etc.) - this seems to be spread among themes S3-S5, S8, and S9. |
| 04/18/2005 |
08:26 |
PU |
381 |
S |
The
development of methods for the centralized automated real-time
monitoring of infectious diseases should be included as a priority-
especially disease in travelers who may be the sentinel cases. |
| 04/18/2005 |
07:27 |
PU |
376 |
S |
Research
should be done on systems of care for children with mental health
problems building on the national evaluation of the SAMHSA funded
Comprehensive Community Mental Health Services for childrn and Their
Families Program. |
| 04/18/2005 |
06:24 |
PU |
374 |
S |
Good that area includes consideration of data collection. Some of the examples are similar to cross cutting topics. |
| 04/15/2005 |
14:13 |
PU |
361 |
S |
The
greatest contribution CDC could make to the safety and health of the
public is to begin a dialogue on the delivery of health care in our
communities in a non-partisan, non-ideological, open discussion.
Promote objective reviews and educational forums to educate the public
on both the short-comings and the advantages of our current approach to
health care delivery. Leave no stones unturned. Review the AMA, the
health insurance companies, our legal system, the educational system,
and federal funding. Present alternative approaches that other
countries have employed to avoid our deficiencies and report
objectively their failures and successes. If the American public had
the objective information they need to evaluate our health care system,
we would not have the system we now have and millions of lives would be
saved annually. This is an annual loss greater than any plaque or war
our country has endured. This could be the number one accomplishment of
CDC in this century. |
| 04/15/2005 |
12:28 |
PU |
355 |
S |
The
Emergency Medicine Network (EMNet, www.emnet-usa.org) at Massachusetts
General Hospital strongly supports the CDC’s Theme S 12 (Health
Communication). In particular we believe that the emergency department
(ED) is an untapped opportunity for health education, both for patients
and families. Pilot work on health education in the ED, by EMNet
investigators, shows strong patient interest in learning about asthma,
smoking cessation, and other public health topics while in the ED. We
believe that the ED can serve as an appropriate and useful venue for
health education and encourage further development of such strategies. |
| 04/15/2005 |
09:54 |
PU |
352 |
S |
Communiciation is important especially for those who who cannot read English |
| 04/15/2005 |
09:54 |
PU |
351 |
S |
Communiciation is important especially for those who who cannot read English |
| 04/15/2005 |
09:34 |
PU |
350 |
S |
I
would like to see greater effort focused on finding the cause(s) of
SIDS. I have worked in Law Enforcement for over 15 years and have seen
firsthand the devistation it has caused families. I have been in the
homicide unit for the past 5 years and our protocol requires a response
to all infant death scenes. I feel that a national standard/protocol
regarding infant death investigation could assist with gathering
valuable data that may help lead to a greater understanding of SIDS and
therefore prevent needless deaths. |
| 04/14/2005 |
18:12 |
PU |
341 |
S |
Hello,
I am an advocate for those who suffer from chronic pain, as well as for
individuals/survivors of sexual assault. In regard to public health
information services, I would like to see: research on multicultural
perspectives on pain and healing and sexual assault understanding or
perspective, psychological type studies/investigations in understanding
the social impact of pain and the contrast/difference in those with
proper support systems (what can the public do to enhance this ect),
and research on community perpectives on sexual assualt (does the
community still shun victims/survivors). In addition, more research is
needed to investigate any positive or negative reactions/connections of
alternative methods of treatment for both pain and sexual assault
individuals. Also, if possible, more public knowledge and awareness is
needed to inform (parents, youth, children, ect.) of the overwhleming
amount of sexual harrassment and victimization on the internet; which I
see as a public health concern. Finally, would there be any possible
studies to find the outcome of community services for people who suffer
from pain or sexual assault - as I have heard endless times how they
would not have made it without help ect. (therefore to ultimatley have
this informaiton - if it confirms what I already know - to gain more
support from federal and local government for funding to support so
many failing public servcie 501 c3 organizations) visually representing
the life saver that floats in an ocean, often with no land in sight.
Thank you for the availability for me to speak my voice. If any of
these ideas apply more to other sections, please forward. Sincerely,
John |
| 04/14/2005 |
15:48 |
PU |
339 |
S |
Technology
has birthed a volume of information - need to address quality of
information and a means to evaluate the information without spending
alot of time. |
| 04/14/2005 |
14:18 |
PU |
337 |
S |
No comments. |
| 04/14/2005 |
13:26 |
PU |
332 |
S |
These
research topics cannot fruitfully be undertaken in isolation from
specific programmatic areas. Care needs to be taken in implementation
of this research agenda to assure that these activities are undertaken
as part of specific programs.
Data exchange with immunization registries should be noted under
"Electronic medical records." |
| 04/14/2005 |
13:22 |
PU |
331 |
S |
LIke translating public health messages into practice. |
| 04/14/2005 |
12:30 |
PU |
326 |
S |
Greater
emphasis should be placed on developing internet based MIS, HIS, and
GIS systems for gathering and disemminating PH and health service
information. Also, explore ways to link the 3 in ways that encourage
stronger partnerships among NGO health providers and the federal, state
and local PH providers |
| 04/14/2005 |
12:19 |
PU |
325 |
S |
Please
include the following:
1) More HIV and STD Messages for teens.
2) Holistic approach to hiv prevention messages
3) Developing a curriculum to train doctors on how to deliver messages
in a manner that does not admonish them but instead encourage patients
to take ownership for their health
5) CDC should get more involved with technology re: the delivery of
health information. 6) Monitoring the quality of health information
provided on internet
7) Recruiting individuals from the community who can more effectively
transfer health information to those disproportionately affected.
8) Empowering the patient to ask those questions that are typically
afraid to ask their health care provider-many of these questions are
brought up with community based organizations.
|
| 04/14/2005 |
11:43 |
PU |
318 |
S |
Some
ideas in data collection methodology are mentioned, although these
could be more specific, covering numerous facets of measurement error
related to survey samples, questionnaires, interviewer effects, mode of
data collection, imputation, and others. Such research could actually
apply to many of the focus areas and should not be limitd to health
information services research. |
| 04/14/2005 |
11:05 |
PU |
315 |
S |
Need
to provide information for the public and clinicians on laboratory
testing - create a resource where the public can found out which tests
are generally accepted and which are controversial and shy. |
| 04/14/2005 |
10:41 |
PU |
312 |
S |
I
strongly suggest a modification to the ID# S7 theme title:
"[Geospatial] Information and Data Visualization." This theme pertains
to georeferenced or geospatial information. Geospatial information can
be nominal, address matched (geocoded) or located through latitude and
longitude. The term "geospatial" conforms to OMB's Federal Geographic
Data Committee (of which I represent DHHS) designation of terms, is
universally identified in metadata and data dictionaries of all federal
agencies, and is a standardized term for georeferenced information
provided by state and local public health departments. [Please contact
me if there are any questions: Chuck Croner at cmc2@cdc.gov, NCHS] |
| 04/14/2005 |
10:39 |
PU |
311 |
S |
H14,
H15
I'm no expert - but seems the lion's share of chronic disease burden is
caused by US. How can we partner with other industries (food, health
care) to help US? |
| 04/14/2005 |
10:31 |
PU |
308 |
S |
What
is the effect of functional illiteracy in the US on the ability of the
US to maintain higher standards of health? Put in a plug for improving
education, because it is a primary determinant of health. |
| 04/14/2005 |
10:30 |
PU |
307 |
S |
We
have created a Diabetes Indicators and Data Sources Internet Tool that
has identified 38 diabetes indicators and its associated data sources
and their specifications. Having most of the diabetes-specific
information needed for diabetes surveillance has been a tremendous
help. Wish we could expand this to include sections on data analysis
methodology, etc. For programs with limited resources and capacity,
this is a big help and promotes efficiency and consistency in addition
to the obvious accuracy and quality in data analysis. |
| 04/14/2005 |
09:45 |
PU |
300 |
S |
Up to date data on causes and costs of vision impairment throughout the USA |
| 04/13/2005 |
16:31 |
PU |
290 |
S |
THis
is a critical area that needs research. A recent review conducted by
the RAND Evidence Based Practice Center has found that despite the
extensive resources placed in IT and support, there isvery little
research in this area. |
| 04/13/2005 |
15:19 |
PU |
283 |
S |
This
should include technology to support training. For example,
effectiveness of the new learning management system. I noticed that
there was a section for training in the cross-cutting issues also. |
| 04/13/2005 |
15:13 |
PU |
281 |
S |
For
Theme ID S11: add
Explore the opportunites of Personal Health Records and investigate
strategies that consumers are currently using to seek and manage
personal health information. |
| 04/13/2005 |
10:22 |
PU |
272 |
S |
Evaluations
of media such as social marketing consumer-focused campaigns would be
very helpful. For example:
Comparisons of radio vs. print as a means of reaching parents with
science-based prevention messages
Assessments of print campaigns focused on multi-cultural audiences
(cultural adaptations of substance abuse prevention booklets,
incentives, and or innovative distribution channel such as
ethnic-oriented stores, etc.) |
| 04/13/2005 |
09:59 |
PU |
271 |
S |
We
must do a better job conveying our surveillance and reference services
to the general population. Our current stifling security measures
concerning web based databases must be more logically applied. For
example, The CDC has the most comprehensive searchable M protein
database in the world (currently streptococcal multivalent M vaccine is
estimated to be 3-5 years from licensure). Yet results from this
frequently used database (thousands of hits per year), used globally by
vaccine researchers and others, relies on error-prone email-based
servers. Surely the CDC can do better!! I also feel that we should
generally convey critical serotype distribution data in a more timely
manner. We should not rely so much upon publishing certain key data
(which can take an inordinate amount of time), when we can simply
display it very accurately and quickly. |
| 04/13/2005 |
07:49 |
PU |
266 |
S |
Research
priorities National Vision Program /CDC/ DDT
S 2 Data Collection
• Identify, develop and establish strategies to develop efficient and
effective data collection instruments and surveys.
1. Develop best interventions to improve quality checks and ensure the
use of appropriate statistical, analytical, and reporting techniques.
2. Identify the best way to capture and share best interventions.
S 8 Electronic Medical Records (EMR)
• Explore practices and strategies for using electronic and personal
health records for public health.
1. Work with OCHIT in assuring the most effective and efficient use of
electronic eye/health data.
2. Provide public health information to EMR to support the creation of
clinical decision support tools.
3. Provide public health information to EMR to support the creation of
patient decision support tools.
4. Evaluate EMR eye/ health use in health care settings.
5. Monitor and assist with EMR surveillance efforts including
participating in the development of the architectural design of a
coordinated National Health Information Technology (HIT) System.
6. Assure a linkage of eye/health records into all forms of HIT
architectural designs including those related to managed care
organizations, government monitored systems and privately linked
systems.
S 12 Health Communication
• Explore strategies to develop effective tools and practices that will
translate public health messages into health practices and will inform
and motivate people to make behavior changes to maintain healthy
lifestyles, improve their health status, and prevent or minimize the
impact of disease, injury and disability.
1. Explore interactive web designs that would empower individuals with
improved understanding of public health messages.
2. Explore tools; including educational campaigns, that effectively
translate messages into health practices.
|
| 04/12/2005 |
17:58 |
PU |
265 |
S |
I
have 6 comments:
1. Starting with S12, the "examples" provided are far too general --
they are not research activities, but broad categories of research. 2.
The expression "populations who aren't familiar with branded
organizations" strains credulity. What group hasn't heard of Coke? Are
you really talking about populations whose members have negative
associations or no associations with certain organizational brands?
Precise language is necessary even in a "starter list" for a research
agenda.
3. Research cannot identify "best ways." It can show that one way works
under the circumstances tested, and/or that, among several strategies
that are compared, one is superior. You can write clearly without
saying things that are actually scientifically invalid. 4. There is a
redundant example -- developing and testing messages -- in S13 and S17.
What is this an example of? 5. The meaning of the 3rd bullet in S17 is
unclear.
6. The idea of studying message bundling before it becomes CDC policy
is an excellent one. |
| 04/12/2005 |
14:51 |
PU |
264 |
S |
•
Health Information Services: There is a need to tie together
electronically the now disparate dental and medical records systems to
pursue research regarding the systemic/oral relationships. The American
Dental Association, through its Subcommittee on Dental Informatics, has
made significant advances in developing information standards for
dentistry. |
| 04/12/2005 |
11:56 |
PU |
263 |
S |
Very
good list of key issues in health communication and information.
One suggested addition to the Theme list is Media Advocacy. Activities
under this theme could include:
Explore ways for public health professionals to use earned media to
communicate to the public and policy makers about the injury and
disease burden and solutions to reduce this burden. Develop and test
approaches for developing stronger relations between public health
professionals and journalists. Provide journalists will skills to
understand the rates, causes, and solutions to public health problems.
(goal would be to have more and improved coverage of public health
stories) |
| 04/11/2005 |
09:59 |
OH |
251 |
S |
see general discussion comment below |
| 04/11/2005 |
09:26 |
PU |
242 |
S |
Please include data collection on the population categories of:
Sexual orientation (lesbian, gay, bisexual, heterosexual)
Gender identity (male, female, transgender)
Sexual behavior (MSM, WSW, bisexuality, etc.) |
| 04/11/2005 |
09:23 |
PU |
241 |
S |
S16
HEALTH LITERACY -
We would like to endorse and encourage your inclusion of this important
function in the Research Agenda. The CDC Health Literacy Work Group
(currently applied for official status) is working to advance the use
of plain language to promote greater literacy on health and prevention
matters and behaviors among the lay public. As you discuss and work to
incorporate health literacy research as an integral function across
CDC, we want to share the following resources to assist your efforts:
1. Report by the Agency for Heatlhcare Research and Quality (AHRQ),
Literacy and Health Outcomes, published in April 2004 Available at
http://www.ahrq.gov/news/press/pr2004/litpr.htm 2. Report by the
Institute of Medicine (IOM), Health Literacy: A Prescription to End
Confusion, published in April 2004
Summary available at http://www.iom.edu/report.asp?id=19723 3. Health
Resources and Services Administration (HRSA) Resources
Available at http://www.hrsa.gov/quality/healthlit.htm Also, please
look for upcoming articles on the value and utility of health literacy
as a public health function that our Work Group is posting on both CDC
Connects (http://intranet.cdc.gov/) and the CDC Communications
(http://www.cdc.gov/communication/index.htm) websites.
Much continued success in your important work.
Linda Carnes
DHHS Liaison
CDC Health Literacy Work Group |
| 04/11/2005 |
07:49 |
PU |
238 |
S |
Wrong title Should be health services research..... |
| 04/08/2005 |
14:10 |
PU |
234 |
S |
-
Develop web-based tutorials for analyzing complex population surveys
(e.g. NHANES, NHIS, MAMCS, BRFSS, etc) since internet access to these
datasets has greatly expanded the user base and level of expertise.
- Develop the technology and analytic approach/capability for
interactive survey datasets |
| 04/08/2005 |
08:45 |
PU |
232 |
S |
It
would be informative to include here some attention to issues of
whether particular means of health intervention (e.g. pharmacological
versus cognitive behavioral therapeutic interventions for depression)
are being inappropriately over-promoted due to profit or market
considerations rather than due to actual outcome considerations. |
| 04/07/2005 |
19:03 |
PU |
227 |
S |
No comment. |
| 04/07/2005 |
16:14 |
PU |
226 |
S |
Competency
should not be limited to "literacy" and the targeting of "non-english"
speaking individuals. Competency should be broadend to include
components relevant to larger aggregations such as communities,
inclusive of the embedded diversity or heterogeneity. Thus, in addition
to literacy, research should address ways of discerning the
signficicance of history, culture, context, geography, positive
imagery, salient imagery, language, literacy, multi-generational
appeal, and diversity in the development of materials, messages,
research instruments and intervention protocols. |
| 04/07/2005 |
13:47 |
PU |
217 |
S |
Impact research |
| 04/07/2005 |
10:02 |
PU |
207 |
S |
Inclusion of social marketing practices in public health |
| 04/07/2005 |
09:44 |
PU |
205 |
S |
Only
2 general comments:
1) Has the topic of bioethics research as it relates to public health
information and practice been considered in the other focus areas? As
we all know, this can relate to many issues including: a) optimal
approaches to obtain consent for minors to participate in public health
activities; b) standarization of practices for appropriate linkage of
health information; or c) use of stored/maintained biological
specimens.
2) Should research efforts include an ongoing evaluation of the
"parameters of health" to assess deficiencies in current research
approaches or the need for health research changes over time. By
"parameters of health", I am referring to the broad spectrum of
components that can impact health, namely: a) physical or mental health
conditions; b) personal, cultural, or societal behaviors; c) Influences
of economic changes or legal decisions; d) community factors (e.g.
urban planning); or e) health care factors (e.g. changing prescription
drug patterns). |
| 04/07/2005 |
08:45 |
PU |
198 |
S |
Health
information services are a means, not an end. Information services
should assit programs, not dictate policy to them.
CDC successfully aquired almost universal positive recognition by the
U.S. public by helping provide top notch infectious disease expertese;
not by "marketing" hollow messages to them. |
| 04/07/2005 |
06:45 |
PU |
190 |
S |
Important
if not overdone with fancy electronic networks that do little more than
impress. Those that will be used are important, such as links to state
health departments for reporting, recently developed links for online
microbiological diagnostic assistance to physicians and laboratories. |
| 04/06/2005 |
17:47 |
PU |
187 |
S |
Informatics
Evaluation. Develop and identify informatics evaluation methodologies
for health surveillance and reporting systems.
1. Define the conceptual models for informatics evaluation
methodologies.
2. Develop valid evaluation methodogies based in computer science,
operational research, business, and lessons learned.
3. Develop toolkits for dissemination and use. |
| 04/05/2005 |
18:11 |
PU |
172 |
S |
All of these areas are deperately needed in health care. |
| 04/04/2005 |
13:30 |
PU |
156 |
S |
More funding and attention needed. More attention on injury prevention and control is needed. |
| 04/04/2005 |
11:05 |
PU |
147 |
S |
Cool. Media research is needed for the public health field. |
| 04/03/2005 |
21:43 |
PU |
144 |
S |
at
a minimum, add questions to the YRBS that would capture additional data
on childhood drinking such as brand and product preferences,
information about extreme use, ie 10+ or 15+ drinks at a sitting, and
questions for children younger than 6th grade .
the CDC should take up where CAMY is leaving off and monitor alcohol
advertising aimed at the under 21 population
much useful information could be gleaned from death reports if the CDC
monitored every unnatural death for the involvement of alcohol.
S3. be sure to inclued change in rules, regualtions and laws in the
policy changes you evaluate and develop cost benefit ratios in the same
way as they are developed for other programs so the results are
cocmparable.
S5. it would be wonderful if this could be developed so that all the
major AOD surveys could be yield comparable incidence and prevalance
data S6-7-9-12. this would be very helpful to the many communities that
are trying to set common risk and protective factors and ojectives
across all social services in the community and is being promoted by
the SPF/ SIG grants from CSAP/SAMHSA.
S13-18. are important in changing behaviors which needs to be done if
we are ever going to impact the life-style dieseases , including
alcohol that cost us the most money and heart ache. |
| 04/01/2005 |
08:20 |
DC |
142 |
S |
Develop a national data base. Include immunizations. |
| 03/30/2005 |
10:37 |
DC |
131 |
S |
Ability
to communicate from hospitals to MD to health dept to state labs would
improve timeliness of reporting and therefore impact on treatment and
intervention |
| 03/30/2005 |
08:50 |
DC |
123 |
S |
If
the reporting of healthcare acquired infections becomes a requirement,
I feel we need to all have the same reporting computerized system. |
| 03/29/2005 |
10:57 |
DC |
111 |
S |
Timely
release of information should be prioritized. Those in the scientific
community realize that from research to peer reviewed publication often
takes years, but three and five year old data has a hard time being
taken seriously by the public and policy makers. |
| 03/28/2005 |
14:56 |
DC |
104 |
S |
As
Mandatory Public Reporting of Healthcare-associated Infections is what
consumers are asking for, it is imperative that there is a nation-wide
emphasis on a specific healthcare-associated infection reporting data
system that can be risk-adjusted and utilized by all health care
facilities. If not, each state will be devising their own systems that
may mislead the public and impact their trust of the Healthcare
environment. |
| 03/28/2005 |
13:29 |
DC |
102 |
S |
Priority
is preventative health including improved access to health screening
and early health care. Basic health information such as vaccination,
lab screening data, Xrays, etc should be easily accessible by the
person (or parent/legal guardian) when seeking followup health care.
Health findings need to be more easily accessible by the individual
person. |
| 03/28/2005 |
10:19 |
DC |
71 |
S |
User friendly health surveillance and reporting systems. Coordination of the many systems into ONE would be wonderful. |
| 03/28/2005 |
10:14 |
DC |
69 |
S |
Need
more advancement in syndromic surveillance. Better links between our
county health departments and the hospitals and doctor offices. |
| 03/28/2005 |
08:10 |
DC |
59 |
S |
Promotion
of standardization across all information systems is paramount.
Alothough systems exist for surveillance, reporting, etc., they are
very costly and smaller organizations cannot afford them. |
| 03/27/2005 |
16:24 |
DC |
55 |
S |
Utilize more social marketing techniques to disseminate the ALREADY known info so the Public may truly benefit. |
| 03/25/2005 |
11:30 |
DC |
49 |
S |
Research
regarding affordable methods to protect health information from being
compromised by invaders/hackers will need explored. |
| 03/15/2005 |
00:18 |
WA |
25 |
S |
Virtual
PICU and other computer software aids in sharing information and should
be expanded, research dollars are too expensive to have new information
not be shared with other health care groups of similar settings. |
Back
to Top
|
| Date |
Time |
Type |
ID |
Group |
Comment
|
| 04/19/2005 |
22:38 |
PU |
469 |
H |
H5
- Although CDC has a strong focus in the needed area of prevention of
disability, there is not a priority on surveillance and research
related to the needs of people with disability. For instance, in the
well-funded National Breast and Cervical Cancer Early Detection
Program, support of programs to serve the hard-to-reach population of
women with disabilities is minimal or lacking. The program has made an
assumption that these women are covered by Medicaid and thus not
eligible for NBCCEDP services. Yet research, to determine actual
numbers of women with disabilities who fall through the insurance
crack, has not been done. Evidence is available in census and other
surveillance tools to determine a population based need for women with
disabilities within the intended age-range. CDC has not done this basic
study. Thanks. I hope this helps CDC to not overlook this important
population. |
| 04/19/2005 |
17:26 |
PU |
463 |
H |
Kudos
for H11! H14, adolescent health: don't forget about mental health. We
want to prevent suicide and homicide and Columbine incidents by
understanding and improving mental health of at-risk adolescents.
Social determinants of health, and their interaction with other factors
mentioned here (such as genomics), should be thematic for this entire
set. |
| 04/19/2005 |
16:59 |
PU |
462 |
H |
Hello,
dear workgroup:
where have all the occupational exposures gone? The word "occupational"
or "workplace" is nowhere to be found in this document. There are very,
very strong arguments beyond the space allocated here for adding
"workplace exposures" to Theme IDs H3, H4, H6, H10, H12, H14, H15, H17,
H19. We're talking about exposed men and women in the workplace (and
the culpable exposures include a lot more than chemicals: physical
agents including radiation and noise; stress; ergonomic effects which
may impact pregnancy; shiftwork and other circadian disruption or sleep
disturbance) . We're also talking about whether a working mother should
breastfeed. And have you thought about workplaces of handicapped people
(H6) or adolescents (H14)?
It's time to close this exposure gap. Please add occupational exposure
to these questions!
[comment from Barb Grajewski, NIOSH and co-chair, NIOSH's National
Occupational Research Agenda Reproductive Team]
|
| 04/19/2005 |
16:57 |
PU |
461 |
H |
Theme
ID# H14 & H15: I strongly suppport the need for translation
research related to the prevention of alcohol use among adolescents and
alcohol abuse (or, more generally, excessive alcohol consumption) among
adults. I would specifically recommend that additional funding be
provided to assess effective approaches for mobilizing community
support around policy and environmental interventions to reduce
underage and binge drinking, including increasing alcohol excise taxes,
enforcing minimum drinking age laws, and restricting alcohol outlet
density. This translation research would nicely complement the new
chapter on the Prevention and Control of Excessive Alcohol Consumption
that's being developed for the Guide to Community Preventive Services.
However, it would also be useful to conduct additional evaluation
studies to assess the effectiveness of various intervention strategies.
For example, relatively little is known about the impact of
point-of-purchase alcohol marketing and pricing on youth alcohol
consumption. In addition, it would be very helpful to assess the
cross-over effects of policy interventions directed toward one leading
actual cause of death (e.g., alcohol) on another (e.g., tobacco). |
| 04/19/2005 |
16:23 |
PU |
458 |
H |
H-15
Improving Adult Health: This theme puts a disproportionate emphasis on
personal behavior. CDC should also address the social determinants of
health, structural barriers, and the behaviors of health care
providers. In addition, more attention should be given to quality of
life and quality of care issues among persons with chronic diseases.
H-16 Improving Health of Older Adults
This theme puts a disproportionate emphasis on personal behavior. CDC
should also address the social determinants of health, structural
barriers, and the behaviors of health care providers. In addition, more
attention should be given to quality of life and quality of care issues
among older adults with chronic diseases. H-18 Care for Children with
Chronic Diseases - Coordination of care is an important issue for
adults with chronic disease - attention should not be limited to
children.
H-19 The National Children's Study - this is an activity, not a
research theme. If the interest is on the environmental influences on
children's health, attention should also be given to environmental
influences on adult health. This theme fits more appropriately under
Environmental and Occupational Health, NOT Health Promotion. |
| 04/19/2005 |
16:13 |
PU |
457 |
H |
Currently
much of CDC's research is limited to cooperative agreements available
to members of three organizations: Association of American Medical
Colleges (AAMA), Association of Schools of Public Health (ASPH) and the
Association of Teachers of Preventive Medicine (ATPM). There are
respectable and qualified researchers in state and private universities
who do not have a medical school or a school of public health
associated with the university. The CDC reseach agenda should be open
to competition to established researchers who are not members of these
three organizations that are the receipients of umbrella cooperative
agreements. |
| 04/19/2005 |
15:57 |
PU |
456 |
H |
I
believe we have just started to uncover some of the associations
between indicators of mental health, mental illness, and subsyndromal
symptomatology of certain mood disorders (e.g. depression, anxiety)
with chronic disease and disability. I believe it is appropriate that
work in these areas continue and is designated a research priority. |
| 04/19/2005 |
15:43 |
PU |
453 |
H |
It
would be useful to engage in research that addresses the many people
with more than one disease--comorbidities--and how best to reach them. |
| 04/19/2005 |
15:31 |
PU |
452 |
H |
The
group name needs to be changed. We need a specific group for Chronic
Disease Research similar to the one for Infectious Disease Research.
Health Promotion is a cross-cutting objective or content area rather
than its own research group. The research themes are disportionately
high for pregnancy, birth defects and developmental disabilities, and
child development (H1-H7; H12) and Genetics (H8-H11) in comparison to
the three lifespan research themes for all of chronic disease plus
injury, violence, HIV infections, STDs and unintended pregnancy
(H13-H16). The examples of research activities are very specific for
H1-H12 but not for H13-H16 where all of chronic disease is lumped
together. Compare H4 to H15. The disportionate number of research
themes does not reflect the disease burden in the US or the number of
CDC employees working in these areas. Also, what is new in the research
activities for H15? All of that is being done now and much of it isn't
considering research but just routine surveillance. e.g., (Describe the
burden of and risk factors for chronic conditions). This is research??
I think this area needs extensive reworking and input from a broader
group of people. This reads as though employees working in reproductive
health, birth defects and developmental disabilites, and genetics were
either more involved in the drafting of this section or were more
successful in getting their issues to the forefront than members from
chronic disease research areas. |
| 04/19/2005 |
15:17 |
PU |
451 |
H |
Add 1) integrated chronic disease programs and 2) practice-based evidence. |
| 04/19/2005 |
14:33 |
PU |
448 |
H |
There
was nothing in this plan about combining mental health in with
traditional notions of physical health, and nothing about studying the
effects of "alternative" therapies and integrating these in with
community based health interventions, such as yoga and meditation. |
| 04/19/2005 |
14:20 |
PU |
446 |
H |
H2
– Development of programs for better identification of children with
fetal alcohol syndrome
H3 – Development of educational campaigns to warn women of dangers of
alcohol use during pregnancy and measure the effectiveness of such
educational campaigns
H17 – Include in the community-based participatory research efforts
focused on reducing binge drinking in communities
|
| 04/19/2005 |
14:04 |
PU |
443 |
H |
For
Theme H12, this area is lacking in several important areas of research
and especially in the reducing extrememe disparities in birth and
maternal outcomes among women of color and the majority populations.
Studying the Mechanisms of pre-term delivery is a good start, as is
increasing access and quality of care before, during and after
pregnancy. Overall this whole list has too much emphasis on genomics (5
themed areas of 20), an area where we don't know as much about with
regards to public health impact, what can be done about such factors,
and where there are still vast ethical concerns and cost-prohibitive
intervention (especially in H8). Contrast that to areas where we need
to understand emerging issues of child development (H1, H2, H7),
addressing inequitable birth outcomes (H3, H4, H12). The genetics stuff
is important to have on the agenda, but in light of the importance of
lifestyle factors that we already know are effective, this list seems
to give little priority to eliminating health disparities and promoting
healthy lifestyles for all regardless of genetics. There needs to be
more about promoting research on interventions that work on reducing
the health risks to development we already know about: lead poisoning,
heart disease, exposure to toxins, air pollution, and poor living
conditions, reducing smoking during before and after pregnancy, etc. |
| 04/19/2005 |
12:21 |
PU |
435 |
H |
Theme
H16
Study the actual behavioral and environmental contributions to
longevity. what factors most support living long and healthy life? What
is economic impact of not providing preventive care and promoting
healthy environments that support healthy living? |
| 04/19/2005 |
12:03 |
PU |
434 |
H |
This
is a very comprehensive and well designed plan. I would encourage the
committee to think about addressing the specific health needs of
foreign born and refugee populations as they related to increased needs
and in preventing the spread of contagious disease. |
| 04/19/2005 |
11:45 |
PU |
432 |
H |
Continue
to expand research efforts in follow-up after diagnosis of hearing loss
among infants and young children (0 - 4 years) for both hearing loss
and speech disorders. |
| 04/19/2005 |
11:18 |
PU |
430 |
H |
CDC
needs to better coordinate and utilize scarce resources. It seems that
many of the genomics activities overlap NIH activities and divert
resources away from other, more difficult prevention activities. The
genomics activities further perpetuate prevention activities dependent
on allopathic medical care and thus continue the fostering of
disparities and blaming the victim. Much more resources should be
devoted to population-based, societal impacts on health (not disease). |
| 04/19/2005 |
10:59 |
PU |
428 |
H |
distinct
focus on maternal health, nationally and worldwide, to reduce maternal
morbidity and mortality and improve fetal, neonatal and child health |
| 04/19/2005 |
10:23 |
PU |
423 |
H |
I
recommend that the research activities for H.5 include: Determine
infectious disease prevention strategies specifically for persons with
developmental or physical disabilities and ways to provide eduction on
these strategies for persons with disabilities, especially for those
persons with special learning needs (i.e., visual, hearing, or mental
impairment).
I oppose H.9, H.10, and H.11 on the grounds of privacy, stigma, and
negative impact on persons' insurability.
I recommend that the first research activity for H.14 include
individual-level and group-level interventions.
I recommend that the first research activity for H.15 include
individual-level and group-level interventions. |
| 04/19/2005 |
09:59 |
PU |
422 |
H |
There
is an unwarranted and unbalanced emphasis on child health related
research (10 themes) compared to adult health (2 themes). No identified
chronic disease prevention themes except imbedded in lifestage goals,
whereas birth defects , disabilities and genetics all have identified
themes. |
| 04/18/2005 |
16:26 |
PU |
414 |
H |
Create special focus on disparities (ses, race, etc.): as applies to adult & child health (ie: tobacco use, etc.). |
| 04/18/2005 |
16:04 |
PU |
412 |
H |
Although
Mental health and Substance Abuse are listed in the Cross-cutting
Research category. I think that mental health deserves a greater focus
in the health promotion area. For example, there is increasing evidence
that depression is linked to health conditions such as heart disease. I
am working in the area of physical activity and mental health benefits.
I am sure that there are other connections people can make in terms of
health promotion and mental health. The CDC Mental Health interest
group can be helpful in this regard. Thank you for the opportunity to
provide input. |
| 04/18/2005 |
15:37 |
PU |
411 |
H |
The
theme titles and examples seem to be disease, individual care issues
rather than what is the long time definition of health promotion
relating to policy, systems and ecological approaches, such as the
Healthy Communities (H 17).
There is also a lack of cross-cutting risk factors such as tobacco
use/exposure, nutrition, physical activity, which needs additional
research in the areas of policy, social support systems, community
collaboration, etc. Suggest building on behavioral and social science
lit. that exists. |
| 04/18/2005 |
15:10 |
PU |
408 |
H |
As
a Medical Anthropologist who previously worked at CDC as a Post
Doctoral Fellow, I strongly encourage the institution to support more
behavioral research specifically in areas such as cultural behavioral
patterns within all chronic disease prevention programs. |
| 04/18/2005 |
15:01 |
PU |
407 |
H |
I
realize that the examples given next to each area are not comprehensive
but they appeared to favor certain areas more than others. Why is
fitness used in multiple examples (H13-14) when other health promotion
areas are barely mentioned? Why is depression and psychiatric disorders
mentioned only for older adults? These are issues for children,
adolescents, and adults as well. |
| 04/18/2005 |
14:44 |
PU |
406 |
H |
Patients
with developmental disabilities are very much understudied. As
neuroscience has moved forward, this population with the most to gain
has been left far behind. Please fund research into making their lives
better! |
| 04/18/2005 |
13:47 |
PU |
402 |
H |
The
themes that recur within this document include childhood issues,
persons with disabilities, genetic issues that relate to chronic
diseases, with adolescent and adult health almost an after thought. |
| 04/18/2005 |
13:42 |
PU |
401 |
H |
Include
communication disabilities across the age span, including speech
(articulation, voice, fluency) and language (receptive and expressive
in areas of phonology, morphology, syntax, semantics, pragmatics) |
| 04/18/2005 |
13:42 |
PU |
400 |
H |
I
am unclear as to the purpose of the CDC wide agenda, and how it will be
used to guide decision making. I've reviewed the HPDP agenda. There is
a lack of specificity, and lack of rationale explanation for why some
items are a priority and why others are not. The NCCDPHP research
agenda of several years ago is a better approach. |
| 04/18/2005 |
13:16 |
PU |
398 |
H |
CVD
and its risk risk factors (which are greatly increasing in their
prevalence) are a global problem not just limited to industrial
countries but also is rising in the developing areas such as China and
Africa. By 2030, there will be 24 million annual deaths world-wide will
be due to heart disease and stroke and 6 million will be in China--much
of it related to increasing obesity and high blood pressure. We need
more primary and scondary prevention and translation research
addressing how best to remove barriers and improve compliance with
treatment, lifestyle, policy, and environmental recommendations.
CDC needs to make significant efforts to improve the effectiveness of
the IRB and OMB review processes because the extensive delays (perhaps
due to staff shortages) are causing signifcant harm to the conduct of
research. OMB clearance is, by law, to be completed in 60 days but the
average clearance time is 12 months at CDC. And IRB isn't much better. |
| 04/18/2005 |
12:35 |
PU |
394 |
H |
Dear
Spengler and Dr. Wagner:
Thank you for asking the Tourette Syndrome Association, Inc. (TSA) to
comment on the CDC Health Protection Research Guide, 2006-2015. We are
excited about the opportunity and look forward to positive outcomes.
Unfortunately I was unable to attend, nor was I able to send my staff
to any of the four Public Participation Meetings. The very quick turn
around time precluded our participation.
We at the TSA feel it is very important to include the External
Partners in any discussion and subsequent agenda development. I
encourage the CDC not to move forward without input from each member of
the External Partners Group. The themes you have identified in focus
area #5 are of great concern to the TSA and the people we serve. We are
concerned that our inability to participate in this process at this
time, will keep issues effecting people with Tourette Syndrome from
inclusion in this most important Agenda.
We look forward to hearing from you and having the opportunity to
provide our input.
Sincerely,
Judit Ungar
President
Tourette Syndrome Association, Inc.
judit.ungar@tsa-usa.org |
| 04/18/2005 |
12:19 |
PU |
393 |
H |
The
Starter List for this category leans too heavily towards victim blaming
and genetics. While it is important to both help individuals change
their behaviors and to understand the contribution of genetics, it is
much more important and the benefits are much greater if we place the
emphasis on understanding the social and environmental contexts that
encourage, promote and most importantly enable healthy living. |
| 04/18/2005 |
12:11 |
PU |
392 |
H |
Study
rates of addictive behaviors over time (including overeating) to see if
they are on the increase; study ways public health could help prevent
or treat these problems |
| 04/18/2005 |
11:45 |
PU |
391 |
H |
EXCLUSIVE BREASTFEEDING TO BE PROMOTED FOR THE FIRST 6 MONTHS OF LIFE AND THE IMPACT ON CHRONIC ILLINESSES- DIABETES,
OBESITY, HIGH CHOLESTERAL LATER IN LIFE. |
| 04/18/2005 |
11:44 |
PU |
390 |
H |
Research
Theme: Health Professional Training and Treatment Impact
| |