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Oregon City, Oregon, United States

Zlot A.I.,Oregon Genetics Program | Valdez R.,Centers for Disease Control and Prevention | Han Y.,Health Promotion and Chronic Disease Prevention Program | Silvey K.,Oregon Genetics Program | Leman R.F.,Office of Disease Prevention and Epidemiology
Public Health Genomics | Year: 2010

Background: Family history of cardiovascular disease (CVD) is an independent risk factor for CVD. Therefore, efforts to prevent CVD among asymptomatic persons with a family history are warranted. Little is known about preventive recommendations clinicians offer their patients with a family history of CVD, and adherence to preventive recommendations by patients at risk for CVD has not been well described. Methods: We used the 2007 Oregon Behavioral Risk Factor Surveillance System to evaluate among 2,566 adults without CVD associations between family history of CVD and (a) clinician recommendations; (b) perceived risk of developing CVD; (c) adoption of preventive and screening behaviors; and (d) risk factors of CVD. Results: Compared with adults with no family history of CVD, those with a family history reported that their clinician was more likely to ask about their family history information (OR = 2.6; 95% CI, 1.9-3.4), discuss the risk of developing CVD (OR = 2.0; 95% CI, 1.6-2.5), and make recommendations to prevent CVD (OR = 2.1; 95% CI, 1.7-2.7). Family history and clinician recommendations were associated with a higher likelihood of reported changes in diet or physical activity to prevent CVD (OR = 2.7; 95% CI, 2.3-3.2). Persons with a family history of CVD were more likely to report having high cholesterol, having high blood pressure, taking aspirin, and having had their cholesterol checked. Conclusion: The presence of a family history of CVD appears to prompt clinicians to recommend preventive changes and may motivate patients without CVD to adopt these recommendations. Copyright © 2010 S. Karger AG, Basel. Source


Ong K.L.,Atlanta Research and Education Foundation | Ong K.L.,Centers for Disease Control and Prevention | Apostal M.,California Emerging Infections Program | Hurd S.,Connecticut Emerging Infections Program | And 3 more authors.
Clinical Infectious Diseases | Year: 2012

Background.Postdiarrheal hemolytic uremic syndrome (HUS) is the most common cause of acute kidney failure among US children. The Foodborne Diseases Active Surveillance Network (FoodNet) conducts population-based surveillance of pediatric HUS to measure the incidence of disease and to validate surveillance trends in associated Shiga toxin-producing Escherichia coli (STEC) O157 infection.Methods.We report the incidence of pediatric HUS, which is defined as HUS in children <18 years. We compare the results from provider-based surveillance and hospital discharge data review and examine the impact of different case definitions on the findings of the surveillance system.Results.During 2000-2007, 627 pediatric HUS cases were reported. Fifty-two percent of cases were classified as confirmed (diarrhea, anemia, microangiopathic changes, low platelet count, and acute renal impairment). The average annual crude incidence rate for all reported cases of pediatric HUS was 0.78 per 100 000 children <18 years. Regardless of the case definition used, the year-to-year pattern of incidence appeared similar. More cases were captured by provider-based surveillance (76%) than by hospital discharge data review (68%); only 49% were identified by both methods.Conclusions.The overall incidence of pediatric HUS was affected by key characteristics of the surveillance system, including the method of ascertainment and the case definitions. However, year-to-year patterns were similar for all methods examined, suggesting that several approaches to HUS surveillance can be used to track trends. © 2012 The Author. Source


Liko J.,Oregon Immunization Program | Robison S.G.,Oregon Immunization Program | Cieslak P.R.,Office of Disease Prevention and Epidemiology
Clinical Infectious Diseases | Year: 2014

A 2012 pertussis epidemic in Oregon afforded an opportunity to measure vaccine effectiveness; it ranged from 95% (95% confidence interval [CI], 92%-97%) among children 15-47 months of age to 47% (95% CI, 19%-65%) among adolescents 13-16 years of age. In all age groups, pertussis incidence was higher among unimmunized persons. © 2014 The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. Source


Zlot A.I.,Oregon Genetics Program | Cox S.L.,Oregon Genetics Program | Silvey K.,Oregon Genetics Program | Silvey K.,Oregon Health And Science University | Leman R.,Office of Disease Prevention and Epidemiology
Public Health Genomics | Year: 2012

Family history is an independent risk factor for many chronic conditions. Therefore, efforts to prevent these diseases among asymptomatic people at high familial risk are justified to reduce the health burden of these chronic conditions. We analyzed 2006-2009 Oregon Behavioral Risk Factor Surveillance System data to examine associations between family history of diabetes, cardiovascular disease (CVD), colorectal cancer (CRC), breast cancer (BC), and: (1) patient-reported clinician recommendations, (2) adoption of preventive and screening behaviors, and (3) chronic disease risk factors among respondents without a personal history of the condition. A positive family history was associated with a higher likelihood of reported discussion by clinicians of CRC and BC screening and a greater likelihood of respondents having cholesterol and CRC screening. The combination of family history and clinician recommendations significantly increased the odds of CRC and BC screening compared to family history alone. A positive family history was also associated with respondents reporting lifestyle changes to prevent diabetes, CVD, and CRC, but not BC. Awareness of family history prompts clinicians to recommend screening and may motivate patients to be screened. Understanding positive family history may also motivate patients to adopt healthy lifestyles. Copyright © 2012 S. Karger AG. Source


Pilishvili T.,Centers for Disease Control and Prevention | Zell E.R.,Centers for Disease Control and Prevention | Farley M.M.,Emory University | Schaffner W.,Vanderbilt University | And 8 more authors.
Pediatrics | Year: 2010

OBJECTIVE: We conducted a case-control study to evaluate risk factors for invasive pneumococcal disease (IPD) among children who were aged 3 to 59 months in the era of pneumococcal conjugate vaccine (PCV7). METHODS: IPD cases were identified through routine surveillance during 2001-2004. We matched a median of 3 control subjects to each case patient by age and zip code. We calculated odds ratios for potential risk factors for vaccine-type and non-vaccine-type IPD by using multivariable conditional logistic regression. RESULTS: We enrolled 782 case patients (45% vaccine-type IPD) and 2512 matched control subjects. Among children who received any PCV7, children were at increased risk for vaccine-type IPD when they had underlying illnesses, were male, or had no health care coverage. Vaccination with PCV7 did not influence the risk for non-vaccine-type IPD. Presence of underlying illnesses increased the risk for non-vaccine-type IPD, particularly among children who were not exposed to household smoking. Non-vaccine-type case patients were more likely than control subjects to attend group child care, be male, live in low-income households, or have asthma; case patients were less likely than control subjects to live in households with other children. CONCLUSIONS: Vaccination with PCV7 has reduced the risk for vaccine-type IPD that is associated with race and group child care attendance. Because these factors are still associated with non-vaccine-type IPD risk, additional reductions in disparities should be expected with new, higher valency conjugate vaccines. Copyright © 2010 by the American Academy of Pediatrics. Source

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