| Date |
Time |
Type |
ID |
Group |
Comment
|
| 04/20/2005 |
09:53 |
PU |
473 |
C |
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
Comparison of providers and their relative success in identifying new
cases of (e.g. eye disease) and success in referring for specialty
treatment.
Look at general physicians, nurses, LPN’s PBA’s, etc. and how each
group does with case finding and why.
Research Theme: Vision Screening
Measure community-level interventions related to adult vision
screening, referral, follow up, and brought to treatment versus public
and professional education versus doing nothing.
Assess vision screening tools for sensitivity and specificity,
particularly screening related to glaucoma and diabetic retinopathy.
Research Theme: Children’s Eye Care
Measure need and long-term economic and educational impact of
children receiving early vision screening/eye exam versus children
receiving no eye care services.
Measure # of children who get their vision assessed and where –
primary care setting, eye doctor, early childhood education setting.
Research Theme: Measure Impact of Diabetes on Vision
Measure obesity data and its impact on diabetes and the development
of diabetic retinopathy.
Measure the rate and onset of diabetic retinopathy in obese
adolescents with diabetes.
Add “vision loss” to e.g. in H16.
http://www.rsvpbook.com/custom_pages/792_public_comment.php
|
| 04/18/2005 |
11:15 |
PU |
389 |
H |
Excellent start concerning topics of vital importance, but that are often overlooked. |
| 04/18/2005 |
10:21 |
PU |
388 |
H |
I
feel we need to do whatever it takes to fund the National CADDRE study.
It is the most comprehensive study of its kind looking into risk
factors for and causes of autism. In order to say we are doing all that
we can for those affected with autism, this study is an absolute
necessity. |
| 04/18/2005 |
10:00 |
PU |
386 |
H |
Theme H-16: Improving Health of Older Adults - add tobacco cessation. |
| 04/18/2005 |
09:41 |
PU |
385 |
H |
I
noticed under Cross-Cutting Research there was a suggestion to address
mental health and substance abuse. Under "Improving Adolescent Health"
there is no mention of addressing mental health among adolescents. This
needs to be included for both children and adolescents, since mental
health is related to behaviors. Also, I didn't see a mention of quality
of life in this section for adolescents and adults (it was mentioned
for older adults). Measures of life satisfaction and quality of life in
relationship to program evaluation would be salient to examine; the
subjective well-being of individuals at all life stages is important to
consider when thinking about health promotion. |
| 04/18/2005 |
08:36 |
PU |
382 |
H |
Fund
programs designed to help people (especially older adults) obtain a
greater amount of assisance to navigate health services. This will
foster higher quality of life and timely use of appropraite services.
Greater research on understanding and increasing effectiveness of small
dosage follow up education booster sessions for older adults and for
rehabilitative services |
| 04/18/2005 |
07:52 |
PU |
378 |
H |
Research
Theme: Health Professional Training and Treatment Impact
Comparison of providers and their relative success in identifying new
cases of (e.g. eye disease) and success in referring for specialty
treatment.
Look at general physicians, nurses, LPN’s PBA’s, etc. and how each
group does with case finding and why.
Research Theme: Vision Screening
Measure community-level interventions related to adult vision
screening, referral, follow up, and brought to treatment versus public
and professional education versus doing nothing.
Assess vision screening tools for sensitivity and specificity,
particularly screening related to glaucoma and diabetic retinopathy.
Research Theme: Children’s Eye Care
Measure need and long-term economic and educational impact of
children receiving early vision screening/eye exam versus children
receiving no eye care services.
Measure # of children who get their vision assessed and where –
primary care setting, eye doctor, early childhood education setting.
Research Theme: Measure Impact of Diabetes on Vision
Measure obesity data and its impact on diabetes and the development
of diabetic retinopathy.
Measure the rate and onset of diabetic retinopathy in obese
adolescents with diabetes.
Add “vision loss” to e.g. in H16.
|
| 04/18/2005 |
07:27 |
PU |
376 |
H |
Mental
health promotion (including early identification and treatment) should
be a prominent component at every stage of development especially for
infants, children, and adolescents. |
| 04/18/2005 |
06:57 |
PU |
375 |
H |
1)
Under "research Theme...Optimal Child Development" (theme ID H1),
recommend ammending second half of sentence to read:
"...including conditions that cause significant mental or physical
disability or illness, reduced quality of life for children and
adolescents and their families, and death."
2) Under Examples of Research Activities Theme ID H1, add bullet:
"Monitor the benefits, use and outcomes of early identification of and
intervention for developmental disabilities and other cognitive,
social, emotional, or behavioral health problems of childhood and
adolescence."
|
| 04/17/2005 |
12:20 |
PU |
369 |
H |
In H3, "maternal exposures," "environmental exposures" and "social
factors" each include work and outside work issues. If this is not the
intended message, it should be. If this message might be missed, then
the language should be changed to make it clear. Similarly, H9, H12,
H14, H15, and H16 include important workplace aspects. If this is not
the intention, it should be and the language should make it clear. |
| 04/15/2005 |
14:24 |
PU |
364 |
H |
Given
that many of the focus areas of health promotion research deal with
conditions/diseases that are multifactorial, the current research
starter list is too general. A greater specificity within the research
agenda needs to be developed. This specificity should address the
specific risk factors/correlates/determinants of these conditions. For
example, the exploration of the moderators and mediators of physical
activity (a fundamentally important health behavior linked to many
chronic diseases/conditions) needs to be expanded across the spectrum
of prevention - from primary through therapeutic, and
rehabiliative/restorative applications. This level of specificity has
relevance across many of the stated focus areas, especially
child/adolescent health and development; disparities; and disability
(where the consequence of inactivity often far outweighs the
consequence of impairment or presence of a condition per se). |
| 04/15/2005 |
14:22 |
PU |
363 |
H |
The
focus needs to be on differing needs (social, emotional, etc.) and
tasks that people have during various stages of their life span. For
example, the need for socialization and interaction with peers is
especially important for teens and early adults who are trying to meet
the developmental tasks (Erickson's) of trying to establish an identity
and intimacy.
Additionally, research needs to be conducted into how people in
differing life stages react and adjust to the onset of a chronic
illness or disability especially mental illness which is predominately
diagnosed in late adolescence and early adulthood. Last but far from
least..... we need more research into the impact pain medications have
on improving the quality of life of people with painful chronic
disorders and disabilities. Many people are trying to self-medicate
with alcohol and over the counter medications which are more harmful to
their livers that properly administered and supervised long term pain
meds.
Nancy J. Adams, Ph.D. CRC
Assumption College
Wocester, MA
Nadams@assumption.edu |
| 04/15/2005 |
14:15 |
PU |
362 |
H |
To
Theme H14, "Improving Adolescent Health", under "Examples of Research
Activities", would suggest adding the following : " Develop and
evaluate interventions to promote health and prevent secondary physical
and mental health conditions for adolescents with chronic medical
illnesses (e.g., obesity, diabetes, cancer, HIV infection)" |
| 04/15/2005 |
14:13 |
PU |
361 |
H |
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 |
13:36 |
PU |
360 |
H |
Most
important issue. I suggest that CDC fund Evidence-based best practice
community-wide social ecological primary prevention interventions to
address physical inactivity, poor diet and other lifestyle patterns,
instead of fragmenting communities into less meaningful pieces. We must
address lifestyle problems within the context of where people live. |
| 04/15/2005 |
09:34 |
PU |
350 |
H |
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. |
| 04/15/2005 |
07:38 |
PU |
346 |
H |
H
13, H14 It is essential that research be implemented at CDC to better
understand the determinants of what we can do to help keep children
healthy. It is important to study those determinants at the individual,
family, school, and community level. A longitudinal research study such
as Healthy Passages (currently collecting baseline data on 5th grade
children, their parents, schools, and neighborhood) will provide a
scientific basis for the development of social and educational policies
and interventions to help keep children and adolescents healthy. The
study will help us understand the relative contribution of important,
multilevel factors that influence health behaviors and outcomes across
time as well as understand the factors that cause disparities in
health, educational, and social outcomes by race/ethnicity and gender.
As Healthy Passages is designed to assess kids and their parents
biennially until they kids are 20 years old, the study will also help
us understand how to improve adolescent health. |
| 04/14/2005 |
15:48 |
PU |
339 |
H |
Important - whenever can prevent we save money and quality of life. |
| 04/14/2005 |
14:18 |
PU |
337 |
H |
No comments. |
| 04/14/2005 |
13:57 |
PU |
335 |
H |
The
CDC should not focus on genetics except as it relates to birth defects
or elevates risk of occupational diseases. The CDC should be focusing
primarily on the impact of environmental and behavioral factors that
contribute to higher rates of injury and disease, not DNA's
contribution. |
| 04/14/2005 |
13:49 |
PU |
333 |
H |
I
was very happy to see that the item on adolescent health included
reducing unintended pregnancy, but was sorry to see that in the next
column this translated only into reducing unsafe sexual behaviors. It
is obviously critical increase adolescent's knowledge about and access
to contraceptives and abortion services, and those items should be
included in the agenda.
I would also recommend including contraceptive use and access in the
adult health sections. It is inadequate to include only a passing
mention of "improving pre-prgnancy care" but rather an item on women's
health which includes better understanding barriers to contraceptive
use and promoting health sexuality should be included. |
| 04/14/2005 |
13:26 |
PU |
332 |
H |
Maternal
immunization is an important strategy for improving maternal and infant
health and research in this area should be included. Developing
effective strategies for optimal use of vaccines (influenza,
pneumococcal, and ultimately zoster) in older adults should be included. |
| 04/14/2005 |
12:38 |
PU |
328 |
H |
It
seems that we can have the biggest impact by conducting community-based
health promotion efforts that target life-styles and behaviors related
to health. Often, unfortunately, this means getting people stop doing
things considered to present a risk to health. True health promotion
should focus on helping people maximize healthy behavior and life style
choices within the paprameters of their culture and socioeconomic
realities. |
| 04/14/2005 |
12:14 |
PU |
323 |
H |
I
would like to see a proposed research addition to research theme:
"imporve data to better prevent sudden, unexplained infant/toddler
deaths (SUID) in the United States.SIDS is the most common reported
SUID and is the leading casue of infant death among infants 28-364
days. Planned research should include:
* Evaluate the effectivenss of the newly revised Sudden, Unexplained
Infant Death Investigation Reporting Form(SUIDIRF) in improving data
qualitiy on the death certificate.
*Evaluate the utility and acceptability of the SUIDIRF among coroners,
medical expaminers and death scene investigators in the US
*Pilot test and elcectronic reporting system whereby those conducting
infant death scene investigations can submit data from the SUIDIRF
among coroners and medical examiners thus enhancing the the capacity if
the medical examiner/coroner to assign cause and manner of death.
Create a surveillance system whereby thedata from the SUIDIRF would be
submitted to the CDC along wih the death certificate to assist in
monitoring trends and identifying newly emerging risk factors in SUID
*Conduct analytical studies usings data from the electronic system to
identify risk factors amenable to prevention.
Respectfully,
Deborah Robinson
Infant Death Specialist
SIDS Foundation of WA |
| 04/14/2005 |
12:13 |
PU |
322 |
H |
Health promotion research should be placed at number 1. |
| 04/14/2005 |
11:05 |
PU |
315 |
H |
Consider
using family history to stratify risk. The public has not responded
well to the "one message fits all". We need to consider targeted
messages. |
| 04/14/2005 |
10:54 |
PU |
313 |
H |
We
suggest adding a new theme to the "H" list. Our proposed research theme
title and description is, "Improve data to better prevent sudden,
unexplained infant deaths (SUID) in the US". There are currently about
5000 SUID each year in the US. Sudden infant death syndrome (SIDS) is
the most commonly reported SUID and is the leading cause of
postneonatal death, that is deaths among infants aged 28 to 364 days.
Planned research activities include:
* Evaluate the effectiveness of the newly revised Sudden, Unexplained
Infant Death Investigation Form (SUIDIRF) in improving data quality on
the death certificates.
*Evaluate the utility and acceptability of the SUIDIRF among coroners,
medical examiners, and death scene investigators in the US.
* Pilot test an electronic reporting system whereby those conducting
infant death scene investigations can submit data (from the SUIDIRF)
directly to the medical examiners prior to autopsy thus enhancing the
capacity of the medical examiner/coroner to assign cause and manner of
death. *Create a surveillance system whereby data from the SUIDIRF
would be submitted to CDC along with the death certificate to assist in
monitoring trends and identifying newly emerging risk factors in SUID.
*Conduct analytical studies using data from the electronic surveillance
system to identify risk factors amenable to prevention.
Under H12:
We suggest adding the following research activities:
* Conduct analytical studies to determine the risk of morbidity and
mortality among near term infants (aged 34 to 36 weeks) compared to
term infants.
* Conduct analytical studies to determine risk factors for fetal death.
|
| 04/14/2005 |
10:39 |
PU |
310 |
H |
This
research area should include research on the trends in chronic disease
prevalence and disablity prevalence among various age groups (children,
adults & older adults). |
| 04/14/2005 |
10:30 |
PU |
307 |
H |
We
really need to start looking at non-traditional data sources. If >80
percent people with diabetes see their diabetes provider every year how
come <70% report receivng the recommended preventive care services.
We can't dig deeper to find the answer because we dont' know a whole
lot about what their insurance covers and what are the barriers
preventing them from getting these basic tests/exams. |
| 04/14/2005 |
08:07 |
PU |
298 |
H |
Research
Theme: Health Professional Training and Treatment Impact
Comparison of providers and their relative success in identifying new
cases of (e.g. eye disease) and success in referring for specialty
treatment.
Look at general physicians, nurses, LPN’s PBA’s, etc. and how each
group does with case finding and why.
Research Theme: Vision Screening
Measure community-level interventions related to adult vision
screening, referral, follow up, and brought to treatment versus public
and professional education versus doing nothing.
Assess vision screening tools for sensitivity and specificity,
particularly screening related to glaucoma and diabetic retinopathy.
Research Theme: Children’s Eye Care
Measure need and long-term economic and educational impact of
children receiving early vision screening/eye exam versus children
receiving no eye care services.
Measure # of children who get their vision assessed and where –
primary care setting, eye doctor, early childhood education setting.
Research Theme: Measure Impact of Diabetes on Vision
Measure obesity data and its impact on diabetes and the development
of diabetic retinopathy.
Measure the rate and onset of diabetic retinopathy in obese
adolescents with diabetes.
Add “vision loss” to e.g. in H16.
|
| 04/14/2005 |
08:06 |
PU |
297 |
H |
CDC
Recommendations
Research Theme: Health Professional Training and Treatment Impact
Comparison of providers and their relative success in identifying new
cases of (e.g. eye disease) and success in referring for specialty
treatment.
Look at general physicians, nurses, LPN’s PBA’s, etc. and how each
group does with case finding and why.
Research Theme: Vision Screening
Measure community-level interventions related to adult vision
screening, referral, follow up, and brought to treatment versus public
and professional education versus doing nothing.
Assess vision screening tools for sensitivity and specificity,
particularly screening related to glaucoma and diabetic retinopathy.
Research Theme: Children’s Eye Care
Measure need and long-term economic and educational impact of
children receiving early vision screening/eye exam versus children
receiving no eye care services.
Measure # of children who get their vision assessed and where –
primary care setting, eye doctor, early childhood education setting.
Research Theme: Measure Impact of Diabetes on Vision
Measure obesity data and its impact on diabetes and the development
of diabetic retinopathy.
Measure the rate and onset of diabetic retinopathy in obese
adolescents with diabetes.
Add “vision loss” to e.g. in H16.
http://www.rsvpbook.com/custom_pages/792_public_comment.php
|
| 04/14/2005 |
08:06 |
PU |
296 |
H |
CDC
Recommendations
Research Theme: Health Professional Training and Treatment Impact
Comparison of providers and their relative success in identifying new
cases of (e.g. eye disease) and success in referring for specialty
treatment.
Look at general physicians, nurses, LPN’s PBA’s, etc. and how each
group does with case finding and why.
Research Theme: Vision Screening
Measure community-level interventions related to adult vision
screening, referral, follow up, and brought to treatment versus public
and professional education versus doing nothing.
Assess vision screening tools for sensitivity and specificity,
particularly screening related to glaucoma and diabetic retinopathy.
Research Theme: Children’s Eye Care
Measure need and long-term economic and educational impact of
children receiving early vision screening/eye exam versus children
receiving no eye care services.
Measure # of children who get their vision assessed and where –
primary care setting, eye doctor, early childhood education setting.
Research Theme: Measure Impact of Diabetes on Vision
Measure obesity data and its impact on diabetes and the development
of diabetic retinopathy.
Measure the rate and onset of diabetic retinopathy in obese
adolescents with diabetes.
Add “vision loss” to e.g. in H16.
http://www.rsvpbook.com/custom_pages/792_public_comment.php
|
| 04/14/2005 |
07:51 |
PU |
295 |
H |
CDC
Recommendations
Research Theme: Health Professional Training and Treatment Impact
Comparison of providers and their relative success in identifying new
cases of (e.g. eye disease) and success in referring for specialty
treatment.
Look at general physicians, nurses, LPN’s PBA’s, etc. and how each
group does with case finding and why.
Research Theme: Vision Screening
Measure community-level interventions related to adult vision
screening, referral, follow up, and brought to treatment versus public
and professional education versus doing nothing.
Assess vision screening tools for sensitivity and specificity,
particularly screening related to glaucoma and diabetic retinopathy.
Research Theme: Children’s Eye Care
Measure need and long-term economic and educational impact of
children receiving early vision screening/eye exam versus children
receiving no eye care services.
Measure # of children who get their vision assessed and where –
primary care setting, eye doctor, early childhood education setting.
Research Theme: Measure Impact of Diabetes on Vision
Measure obesity data and its impact on diabetes and the development
of diabetic retinopathy.
Measure the rate and onset of diabetic retinopathy in obese
adolescents with diabetes.
Add “vision loss” to e.g. in H16.
|
| 04/13/2005 |
18:52 |
PU |
293 |
H |
This
is a call for CDC to addresses the health disparities mentioned in
Healthy People 20101 regarding race and ethnicity; gender; and
disability. Chapter 19 of the national health agenda1 highlights
disparities in obesity prevalence rates, citing 38% for women with a
disability compared to 25% for women without a disability and 38% for
African American women compared to 23% for non-Hispanic White women.
Funding opportunities are needed to first obtain preliminary data on
the feasibility of a disability-sensitive weight management and health
promotion program for women with physical disabilities. Once
feasibility and then efficacy are establised, large-scale trials should
be funded to ameliorate and/or prevent obesity and overweight in people
with disabilities whose mobility limitations may serve as additional
barriers to exercise and other health behaviors. |
| 04/13/2005 |
16:31 |
PU |
290 |
H |
Given
the growing population of older Americans, this is also one of the top
three research priorities that the CDC coudltake a critical lead on. |
| 04/13/2005 |
15:26 |
PU |
284 |
H |
Would
like to see much more research and dissemination of information on
connective tissue disorders such as Ehlers-Danlos Syndrome, which is
sadly under-diagnosed and may in fact comprise more than 30% of the
Fibromyaligia, Lupus and Chronic Fatigue population. I am President of
an Information & Support group for EDS and speak daily to patients
that have been badly harmed by medical treatments, especially surgery,
which were completely ignorant of EDS complications or that would have
been better cared fro with alternative means such as chiropractic,
massage and accupuncture. The gene for the most prevalent type,
hypermobility, has not been found, nor has proper pain control been
established for these patients. Instead, almost 100% of funds are still
diverted to the Vascular form, which comprises less than 10% of the EDS
sufferers. It has lately been documented that over 38% of the
hypermobile patients may also be at risk for vascular and heart
problems too, so attention to their care needs to be addressed, and
their risks for serious internal problems disseminated for ALL doctors
to learn about. |
| 04/13/2005 |
10:37 |
PU |
273 |
H |
research
on health promotion instead of HIV disease prevention for men who have
sex with men, particulalry in the current HIV epidemic (vs the old AIDS
epidemic) |
| 04/13/2005 |
10:22 |
PU |
272 |
H |
Alchohol, inhalant and other drug prevention as a means of decreasing birth defects long term. |
| 04/13/2005 |
07:49 |
PU |
266 |
H |
Research
Agenda: National Vision Program (NVP) CDC/ Division of Diabetes
Translation (DDT) NCCDPHP
H 1 Optimal Child Development
• Develop a research- to- practice initiative to promote and improve
access to diagnosis, referral and intervention for developmental
conditions of childhood including amblyopia and dyslexia.
1. Implement and evaluate coordinated treatment services for children
with amblyopia and dyslexia.
2. Develop programs that addresses HP 2010 objectives 28.2, 28.3, 28.4.
3. Identify factors that promote or hinder early identification,
diagnosis, and treatment of amblyopia and dyslexia.
4. Determine if refractive errors play a role in social, emotional or
behavioral problems (ie.ADD) of childhood and early adolescence.
H 3 Healthy birth outcomes
• Identify and assess the impact of maternal exposures on birth
outcomes.
1. Identify new risk factors ( CMV, Toxoplasmosis, Toxocariasis, etc.).
2. Implement interventions before and during the pregnancy.
3. Expand primary prevention programs for birth defects.
H 7 Epidemiologic Studies on Child Development
• Study the prevalence of risk factors among children in order to
improve public health planning.
1. Study the possible connection of uncorrected refractive error and
ADD.
H 10 Develop Family History as a Tool for Prevention
• Develop and evaluate strategies that use family history to promote
awareness of risk and motivate prevention behaviors.
1. Activities are being developed to evaluate the usefulness of risk
assessment screening and the usefulness of family history in early
disease detection and intervention of adult vision diseases and
disorders.
2. Develop and evaluate provider and patient education tools.
H 13 Improving Children’s Health • Develop, implement and evaluate
strategies that enable families, schools and communities to improve
children’s health and fitness.
1. Research the most effective ways to increase interventions such as
the delivery of vision health services in school settings.
2. Measure the effectiveness of school policies and programs related to
vision.
H 16 Improving the Health of Older Adults
• Develop and implement strategies to establish and maintain behaviors
during older adulthood that sustain health and reduce the risk of
chronic disease and disability, maintain the quality of life, and
decrease health care costs.
1. Assess the burden and risk factors for chronic eye diseases (BRFSS,
NHANES, Economic Studies).
2. Develop effective public health interventions to prevent or delay
the onset of chronic eye diseases.
3. Prevent or control complications and disabilities that result from
chronic eye diseases.
4. Promote preventive services
5. Develop and implement interventions to maintain quality of life
including both mental and physical.
|
| 04/12/2005 |
14:51 |
PU |
264 |
H |
•
Health Promotion: Oral health care can be difficult to obtain for
children with developmental conditions. Many patient advocacy
organizations exist to support or provide research dollars to expand
research aimed at improving access to care. Cleft lip & palate,
ectodermal dysplasias, and Sjögrens Disease are just a few of the
conditions which could be aided by timely availability of oral health
care. Given the growing evidence of a link between periodontal disease
and low birth-weight babies, the development of model programs for
pre-pregnancy care should include oral care. We commend the CDC for
including research to increase the delivery of needed oral health
services in school settings. School delivery mechanisms are a logical
means to address the low prevalence of preventive services such as
dental sealants, and the lack of needed restorative care in lower
socio-economic groups. Initial studies have shown that tobacco
cessation conducted in the dental office can be effective and are in
fact desired by patients; nonetheless, yet such services are not
offered on wide-spread basis. Dental Practice-based Networks, soon to
be supported by the National Institute of Dental & Craniofacial
Research, may offer an avenue for testing such interventions. Lastly,
oral health issues should most definitely be included in the National
Children’s Study to provide answers to questions related to the
incidence of tooth decay, dental infection and pregnancy outcomes and
to compare total fluoride exposure and enamel fluorosis at the
individual level. |
| 04/11/2005 |
15:51 |
PU |
258 |
H |
This
list seems very broad except for the genetics part. I am not sure how
such a list will help select priorities as I could fit just about
everying under the chronic disease "sun" under this framework. |
| 04/11/2005 |
09:59 |
OH |
251 |
H |
see comment on general discussion below |
| 04/08/2005 |
08:45 |
PU |
232 |
H |
Should
this also include a focus on the prevention of childhood maltreatment,
given research on the long term physical health effects of such
experiences? So, should this category include longitudinal research of
that sort? |
| 04/08/2005 |
07:39 |
PU |
230 |
H |
H17- Impact of SHS policy on community wide health concerns. |
| 04/08/2005 |
07:30 |
PU |
229 |
H |
CDC
should revisit the basic tenets of oral health promotion and disease
prevention. To support public health research that evaluates the
effectiveness of many dental prevention activities that have been place
for decades but have not been systematically evaluated within the past
couple of decades--given the demographic and lifestyle shift of the US,
many of the core dental prevention activities may not be as effective
as they were once. Such research would stimulate the development of
more relevant and meaningful oral health promotion. |
| 04/07/2005 |
19:06 |
PU |
228 |
H |
Please
take into consideration the thousands of community anti-drug coalitions
that are raising awareness of the substance abuse issue, coalescing
communities to address the issue, and developing effectivie strategies
and programs to prevent and reduce substance abuse and its harm to the
community. |
| 04/07/2005 |
19:03 |
PU |
227 |
H |
Research
which attempts to determine why public health meassages regarding
iknown injury prevention strategies, and effectife marketing of these
messages would be very helpful. For example, we need to know how to
make sure that the public health prevention messages are effective with
hard to reach populations. For example how can we do a better job of
convincing low income, high risk-families of the importance of using
seat belts and child passenger safety seats, helmet, etc. |
| 04/07/2005 |
16:14 |
PU |
226 |
H |
Interesting
the heavy focus on genomics. In any case "healthy communities" is
hopefully sufficiently substantive to include targeted efforts to
race/ethnic communities, including L/G/B/T communities.
A focus on disparities would require a targeted effort related to
community development (capacity and infrastructure + social capital).
Baseline measures of capacity and infrastructure (e.g.,
research/researchers, programs, leaders, organizations, networks))
needs to be discerned (new methodologies are needed) and developed
(intervention protocols consistent with an emphasis on community
development). Capacity and infrastructure should be given priority
relative to social capital (e.g., cooperation, collaboration, trust);
although both are important. |
| 04/07/2005 |
16:11 |
PU |
225 |
H |
Please consider dedicating research dollars to what works in the prevention of youth substance abuse. |
| 04/07/2005 |
10:20 |
PU |
210 |
H |
I
would like to see more research on strategies/mechanisms that have been
proven effective in communities for a variety of disease.disability
states but have not been included in 'gold standard' comparison group
studies. For example, the use of promotoras or community health workers
at all levels of research including community mapping, program
development, material production, evaluation planning and implentation,
etc. The advantage is that this proven strategy can be used across
various disease prevention efforts |
| 04/07/2005 |
09:24 |
PU |
202 |
H |
Need to prioritize translation research. Focus should also be specifically on intervention research for prevention. |
| 04/07/2005 |
08:53 |
PU |
199 |
H |
Under
H14(Improving Adolescent Health) and H15 (Improving Adult Health) where
specific diseases are mentioned please include asthma. Asthma along
with emphysema and bronchitis is the 4th overall leading cause of
death, 3rd for those 55-64 year, 4th for those older than 65 years, 7th
for those 5-24 years and 9th for those 45-64 years. Asthma is commonly
believed to be the most common chronic disease of children. Although
there is no cure for asthma currently, health promotion research on
treatment and prevention of exacerbations is crucial to address the
rising prevalence over the last 20 years. |
| 04/07/2005 |
08:16 |
PU |
195 |
H |
For
item H 14 Improving Adolescent Health Develop and implement strategies
to establish health behaviors during adolescence that promote lifelong
health and reduce the risk of the leading causes of illness and death
among youth and adults, asthma is not included. Asthma is a leading
chronic condition among children and youth, a major cause of school
absences (with almost 15 million days lost due to asthma in 2002), and
the 3rd leading cause of hospitalizations among children and youth
under 15. I think this makes it a leading illness among youth, and
therefore, it should be included in the list of health topics decribed
in item H14.
Thanks for considering my request. |
| 04/07/2005 |
07:02 |
PU |
191 |
H |
Consider
the development of an Office of Exercise Anthropology and Extinct
Exercise Epidemiology. One focal question to research is the
evolutionary location of the genetic marker for coronary aretery
disease and diabetes, i.e. how far back in time does the inheritance of
CAD and IDDM occur in hominids? Why did it occur? Can it be reversed?
What, if any, evolutionary genetic protection mechanisms where present?
What were the dietary factors? Were the genetic markers for obesity
present in the early hominids? What differences occured in the physical
activity patterns in nomadic desert dwellers compared to dense
vegetation dwellers; these effects on death rates and birth rates;
these patterns compared to comtemporary physical activity patterns?
Etc., etc., etc. |
| 04/07/2005 |
06:45 |
PU |
190 |
H |
Chronic
diseases resulting from tobacco are the major preventable disease
category in the U.S. Inverstment in this area would be health cost
efficient, very important. Genetic diseases, birth defects,
disabilities also important because of the cost of caring for tvictims
of these. This is not intended as a cold cost/benefit analysis, but in
consideration of family expenses, which are many times unaffordable. |
| 04/07/2005 |
06:44 |
PU |
189 |
H |
Stress
and burnout have been named as influencing factors that lead to risky
behaviors in numerous studies in both clients and providers (i.e., HIV,
STD, smoking, violence, less attention from care providers, less
effective prevention counseling). I respectfully submit the addressing
stress and burnout would improve decision-making skills and decrease
risky behaviors. vem4 |
| 04/05/2005 |
23:13 |
PU |
175 |
H |
obesity
appears to be one of the major challenges public health. research needs
to continue on how to get people to exercise more. |
| 04/05/2005 |
14:55 |
PU |
169 |
H |
CDC
I appreciate the opportunity, on behalf of the Ohio Department of
Mental Retardation/Developmental Disabilities to provide input into
your long-range plan for research projects. My suggestions are the
following:
ˇ Research into the causes of autism and the appropriate treatment once
it has been properly identified;
ˇ Research to help eliminate the effects of Fetal Alcohol Syndrome
(FAS) onthe individual; and
ˇ Public messages around alcohol and drug usage especially to women who
are pregnant or contemplating pregnancy and around child protection
(e.g. shaken baby syndrome, using car seats, etc.)
If you would like detailed information on these topics, I would be
happy to provide that to you.
Thank you
Ken Ritchey, Director
Ohio Department of Mental Retardation Developmental Disabilities |
| 04/05/2005 |
11:11 |
PU |
159 |
H |
See
above comments. Health Promotion should be targeted as a systems level
intervention. That is, at a cultural, school, family, institutional,
religious level. Am interested in establishing a community-wide program
that begins at the local children's Hospital. I am a Ph.D. specializing
in pediatric psychology. How could I get funding to establish a health
promotion program??? |
| 04/04/2005 |
14:19 |
PU |
157 |
H |
I believe that intentional injury should be included in this list |
| 04/04/2005 |
13:30 |
PU |
156 |
H |
More attention on injury prevention and control is needed. |
| 04/04/2005 |
11:47 |
PU |
152 |
H |
The
research priorities should not include chronic diseases prevention
only. It should also include chronic disease control. Because there are
very many chronic diseases that one can not prevent them, but the
control of these chronic diseases are possible. |
| 04/03/2005 |
21:43 |
PU |
144 |
H |
Every
one of these themes should be run through the AOD lens, since FASD is a
developmental disability and childhood alcohol use leads to
developmental delays and disabilities. H1. easy pediatric tests for
FASD need to be developed and used in birthing centers and hospitals
and taaught to docs. beter dianostic tools need to be developed to
determine the placement of a child's FASD disabilities. H2. since FASD
is the only known preventable cause of birth defects, it shoudl get a
high proirity in your studies. moe and more babies andchildren are
coming into the world affected by meth and other drugs and that should
be studied too. schools criminal justice systems and others who deal
with the growing child sould be educated in the signs and symptoms of
FASD and how to interact effectively with FASD children.
H3-4. the ATOD use of mother and father should be assessed, etc.
H5-7. be sure FASD and AOD use is considered in the studies
H8-9. it would be nice to know more about the intergenerational passage
of addiction and the role genes and environment play.
H10. family histories should include a prompt for AOD addictions or
abuse
H12. don't forget the risk of alcohol use/abuse in maternal and child
health. the impact of alcohol in breast milk on the baby's loong and
short term health or increased seceptibilty to later addiction. don't
forget the paternal use of AOD on the babies outcomes.
H13-17. besides measuring and sending to parents the BMI index of
children, like information about school based eye exams, please
evaluate the impact that community anti drug coalitions have in
improving the health of children and families. alcohol is a contibuting
factor of many of hte cronic dieseas you list so inculde community
coaltions in your research.
H19. alot of useful information can be gleaned from the NCS, especially
if alcohol is considered as one of the toxins. whichi it is to the
brain pre- and post-natal. it is a disease with a genetic and
environmental component that needs further study.
|
| 04/01/2005 |
07:08 |
PU |
136 |
H |
Add “vision loss” to e.g. in H16. |
| 04/01/2005 |
06:48 |
PU |
135 |
H |
Research
Theme: Health Professional Training and Treatment Impact
Comparison of providers and their relative success in identifying new
cases of (e.g. eye disease) and success in referring for specialty
treatment.
Look at general physicians, nurses, LPN’s PBA’s, etc. and how each
group does with case finding and why.
Research Theme: Vision Screening
Measure community-level interventions related to adult vision
screening, referral, follow up, and brought to treatment versus public
and professional education versus doing nothing.
Assess vision screening tools for sensitivity and specificity,
particularly screening related to glaucoma and diabetic retinopathy.
Research Theme: Children’s Eye Care
Measure need and long-term economic and educational impact of
children receiving early vision screening/eye exam versus children
receiving no eye care services.
Measure # of children who get their vision assessed and where –
primary care setting, eye doctor, early childhood education setting.
Research Theme: Measure Impact of Diabetes on Vision
Measure obesity data and its impact on diabetes and the development
of diabetic retinopathy.
Measure the rate and onset of diabetic retinopathy in obese
adolescents with diabetes.
|
| 03/30/2005 |
11:55 |
OH |
132 |
H |
As
chief of Communication and Training for Ohio's single state authority
on alcohol and other drug prevention, treatment and recovery services,
I'd like to address the CDC&P's role in raising the awareness of
serious health concerns such as FASD prevention and alcohol and drug
abuse by our youth. Although Partnership for a Drug-Free America and
ONDCP do a good job with a media campaign about drug use, very little
is said about the devastating effects of alcohol use on youth brain
development and the development of the fetus. |
| 03/30/2005 |
10:37 |
DC |
131 |
H |
Disseminate brochures, videos or training material to be used in community wide education |
| 03/30/2005 |
08:48 |
OH |
121 |
H |
A
major research agenda should be mounted on the behavioral and
environmental aspects of preventing obesity. Research suggests that
treatment of obesity is not a promising public health approach. Ergo, a
major initiative is to focus on prevention of obesity among children
and young adults. A second major research agenda for CDC could be
translation research in which evidence based programs are carefully
studied for mechanisms of action. What aspects make the programs
effective? Another dimension to this initiative would involve
dissemination studies in which processes of program diffusion are
studied and refined. A final dimension to this initiative would be
sustainability of effective interventions. Cost-benefit studies could
carefully document esstential program support efforts and the costs of
these efforts. This would create a more realistic conception of program
sustainability. Often it is now assumed that effective programs
generate political and community support once effectiveness is
established. I do not believe this is the case for prevention programs.
Effective prevention tends to undermine public support by reducing the
visiblity of the targeted health problem. |
| 03/29/2005 |
14:18 |
OH |
117 |
H |
Oral
health has implications relevant to all the chronic disease programs
established by the National Center for Chronic Disease Prevention and
Health Promotion (NCCDPHP), including cancer control, diabetes, healthy
aging, healthy youth, heart disease and stroke, nutrition, safe
motherhood, and tobacco. Additionally, several reports have provided
evidence for the potential correlation between oral diseases such as
periodontal diseases, and systemic disorders such as cardiovascular
disease and adverse pregnancy outcomes. For these reasons, the topic of
the role that oral health has on an individual’s overall health should
be added to its research agenda. The feasibility, efficacy and
cost-effectiveness of integrating rapid HIV –testing in dental clinics
were highlighted in the CDC’s Division of Oral Health Research
Opportunities. This should be expanded to include additional infectious
diseases such as the hepatitis B and C viruses, oral diseases such as
caries susceptibly, periodontal disease and oral cancer, and systemic
disease such as diabetes and cancer. Thus, this topic should be
expanded to include research on multiple forms of salivary diagnostics
as well as potential applications, practice implications, economics,
and liability issues. In line with this, research is needed regarding
the role of dentistry in the screening of systemic disease and the
development of guidelines for referral to medical specialties for
corresponding diagnosis and treatment. |
| 03/29/2005 |
10:57 |
DC |
111 |
H |
There
is a disturbing lack of research about tobacco use cessation for youth.
Many people under the age of 18 have been smoking for a few years and
would like to quit, but services are limited and proven programs are
non-existent. Tobacco use is no longer the sexy research topic it once
was, but it is still the number one preventable cause of death. |
| 03/28/2005 |
13:29 |
DC |
102 |
H |
There
is a perceived significant widespread increase in persons with severe
allergies, asthma, autoimmune diseases, lung disease, diabetes, etc.
These conditions seem to be affecting more children, and environmental
issues are a concern. A renewed focus on prevention and control
measures is needed to improve quality of life. |
| 03/28/2005 |
12:40 |
DC |
90 |
H |
Would like to see public service TV ads for handwashing for children and adults. |
| 03/28/2005 |
11:05 |
DC |
75 |
H |
Here
again, it would be nice for all to download and adopt a standardized
educational process which has been carefully researched as to the
effect of the educational approach. |
| 03/28/2005 |
09:17 |
DC |
65 |
H |
Obesity
is a epidemic in North America. This is an important research area to
focus on with the outcome affecting chronic disease and disabilities. |
| 03/27/2005 |
16:24 |
DC |
55 |
H |
They
should use Health Promotion techniques to promote the information they
ALREADY know, instead of "Keeping It a Secret" by using the same old
techniques. |
| 03/25/2005 |
11:30 |
DC |
49 |
H |
Prevention
of obesity needs to top the agenda items. Obesity in children is
becoming far too common. As children age, the incidence of other
chronic diseases that can be related to obesity, such as heart disease,
will continue to rise. |
| 03/24/2005 |
11:51 |
OH |
42 |
H |
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
|
| 03/11/2005 |
07:02 |
GA |
18 |
H |
primary prevention
Contraception |
| 03/04/2005 |
08:23 |
DC |
10 |
H |
1.
Need to emaphasize the need for longitudiinal studies on idenitfying
effective intervention strategies to reduce the incidence of secondary
conditions in people with disabilities.
2. Evidence based practice-health promotion and wellness for people
with disabilities.
3. Disaparities in health screenings for disabled and non disbled
populations. |
| 02/23/2005 |
14:17 |
WA |
3 |
H |
It
will be important to find ways to more fully engage consumers and
patients in their health and health care. Tailoring care to patients'
level of knowledge skill and confidence for self-management is an
important direction for more fully engaging patients. Improving support
for the patient role in care is an important component of quality that
is not currently being measured, but one that could make a huge
difference in costs and outcomes. |
| 02/22/2005 |
09:17 |
OH |
2 |
H |
We
need to recognize that the single biggest public health problem not
already being addressed by NIH is the epidemic of poor quality medical
care. NIH and AHRQ have not responded adequately. Having CDC lead this
effort would be important as a signal that the public health impact of
this problem is enormous. Thus, the best thing CDC could do to promote
health would be to make sure medical interventions are applied and
applied correctly whenever they are appropriate (and are not used when
they are not appropriate). |
Back
to Top
|
| Date |
Time |
Type |
ID |
Group |
Comment
|
| 04/20/2005 |
09:53 |
PU |
473 |
I |
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 |
21:38 |
PU |
468 |
I |
For
antibiotic resistance, should CDC be doing drug trials? That seems out
of character for us. We should be evaluating means of preventing
resistant infections, like vaccines and infection control measures. For
I16, CDC has a clear role in vaccine development also -- we can use our
surveillance data to guide vaccine development (eg, what strains a
vaccine should target). It is also our role to develop and maintain
policies for vaccine use. We also need better surveillance for
influenza, as system for measuring influenza vaccine effectiveness each
year, and improved vaccines for pneumococcal disease in adults. |
| 04/19/2005 |
20:12 |
PU |
467 |
I |
I
10 appears to be a subset of I 13
I 15: with the tremendous reduction in GBS rates, the next most
frequent fatal infection among extremely low birth weight newborns, for
whihc a prevention strategy is nearly identified, is neontal
candidemia, this should be added to your list.
|
| 04/19/2005 |
17:26 |
PU |
463 |
I |
Needs
to be better linked with focus area #1, community preparedness and
response research-- including links to topics like health disparities,
and engaging communities to address health risks. |
| 04/19/2005 |
16:13 |
PU |
457 |
I |
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 |
I |
Comment
1: None of the Research Theme Title and Descriptions relate to the
pathophysiology of infectious diseases. In select instances, such
research provides a direct basis for prevention applications. Some
proposed studies relating to Herpes Zoster are a case in point. Comment
2: Suggested added bullet for "Examples or research activities" for
item I-11 (Infectious Diseases of Vulnerable Populations), with some
explanation: "Determination of the point-prevalence of
immunosuppression in the population (by age)." Immunosuppressed persons
comprise an important population for many CDC programs, e.g., Foodborne
Branch (Listeriosis), Parasitic Disease/waterborne diseases
(Cryptosporidiosis), Healthcare Quality (infection control),
Immunization Program (safety of live-attenuated vaccines, post-exposure
prophylaxis), etc. While prevalence data exist relating to specific
categories of immunosuppression (transplants, HIV, types of cancer),
these are incomplete, and furthermore they do not include the possibly
enormous number of persons on immunosuppressive medications (e.g.,
pulse prednisone, MTX, etc.) for a host of indications. It would be
very useful for many programs at CDC to have better data on this issue,
stratified by age. This could be collected via NHIS survey by asking
respondents a limited number of questions whether they do or do not
meet criteria for immunosuppressed as defined by specific lists of
conditions and medications. Several definitions could be used (e.g.,
criteria of the General Immunization Recommendations). |
| 04/19/2005 |
15:31 |
PU |
452 |
I |
Probably
the best of the bunch in terms of specificity and examples of actual
research activities although again, some activities were not research. |
| 04/19/2005 |
14:07 |
PU |
444 |
I |
Conduct
reasearch to evaluate efficacious approaches to reducing and
elimintating disparities in HIV among ethnic and racial minorities. |
| 04/19/2005 |
10:29 |
PU |
425 |
I |
Suggest
inclusion of rural and frontier areas, especially in regard to
syndromic surveillance focused on emerging infectious disease threats.
Urge particular attention to vector-borne diseases. |
| 04/19/2005 |
10:29 |
PU |
424 |
I |
These
look good.
The importance of appropriately-funded laboratories at CDC cannot be
overemphasized. The labs are not currently funded in adequate amounts
in order to enable them to remain national reference labs/experts in
diagnosis, etc. |
| 04/19/2005 |
10:23 |
PU |
423 |
I |
I
recommend that the research activities for I.13 include: Disseminate
effective disease prevention interventions for implementation in the
"real world." and Identify the best mechanisms for disseminating and
maintaining effective disease-prevention interventions for
implementation in the "real world." [See E.8 and E.9 for parallel
wording; recommendations incorporate X.10] |
| 04/19/2005 |
07:30 |
PU |
418 |
I |
For
theme idea #19 of this section (chronic disease), an important research
activity would be to increase screening, outreach, medical, and support
services to those who are chronically infected with a disease, such as
viral hepatitis. It is important to prevent new infections, but equally
important to find and serve the millions who are already chronically
infected. |
| 04/18/2005 |
18:28 |
PU |
415 |
I |
Further
research is very much needed to support alternative delivery systems
i.e., intradermal administration of flu vaccine and use of lower
doseages i.e., 0.25cc flu vaccine IM healthy adults. |
| 04/18/2005 |
14:03 |
PU |
404 |
I |
For H6 I would add hearing loss.
Fo H7, I would add hearing loss, especially slight/mild-moderate bilater and unilateral hearing loss.
For H12 I would add prevention of non-vaccine preventable congenital infections such as cytomegalovirus and toxoplasmosis. |
| 04/18/2005 |
13:47 |
PU |
402 |
I |
Some
of these themes fit better in other areas - Chronic diseases;
Behavioral sciences, Health Promotion, and Prevention. Also need to try
an prioritize all the competing needs. |
| 04/18/2005 |
11:15 |
PU |
389 |
I |
Carefully
evaluate the cumulative and combined exposure of all ingredients that
children receive via vaccinations to ensure safety before new
vaccinations are recommended in isolation. |
| 04/17/2005 |
18:06 |
PU |
372 |
I |
An
evaluation of all tests used by CDC to determine their specificity and
sensivity and their predictive value positive and predictive value
negative for different prevalence rates. This is important for many
reasons. People should not be treated for diseases or conditions they
do not have and with the fear of biological terrorism, it is especially
important that all scientists involved understand what the probability
of a false positive or false negative result is for any test that is
used. |
| 04/17/2005 |
12:20 |
PU |
369 |
I |
At
least I3, I5 and I6 have clear workplace relevance. If that is not the
intent, it should be and the language should make that clear. For
example, "workplaces" could be inserted in front of "communities" in
the list in parentheses in I3. |
| 04/15/2005 |
16:18 |
PU |
366 |
I |
Some additional suggestions:
1. Economic Analysis of Interventions to Decrease the Use of Antibiotics
2. Changing patterns of meningococcal disease after introduction of the new meningococcal conjugate vaccine. |
| 04/15/2005 |
14:13 |
PU |
361 |
I |
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 |
I |
The
Emergency Medicine Network (EMNet, www.emnet-usa.org) at Massachusetts
General Hospital strongly supports the CDC’s Theme I 1 (Antimicrobial
Resistance). EMNet is currently conducting an AHRQ-VA funded study of
antibiotic use in acute care settings, particularly for respiratory
tract infections. Monitoring current antibiotic use and developing
strategies for prudent future use should be a high priority.
EMNet also strongly supports the CDC’s Theme I 8 (Immunization Services
Delivery Research). EMNet investigators recently completed an analysis
of vaccine administration in the emergency department (Pallin et al.
Vaccine 2005; 23: 1048-1052). While some tetanus vaccination was
common, influenza and pneumococcus vaccination were extremely rare. The
tetanus experience demonstrates that the ED provides a potential venue
for coordinated vaccination efforts. EMNet encourages efforts to expand
and implement vaccination programs, including those based in the ED.
Finally, EMNet strongly supports the CDC’s Theme I 14 (Patient Safety).
EMNet is currently conducting an AHRQ-funded, 85-center study of
patient safety in the emergency department (ED). Results will inform
recommendations for preventing adverse events in the ED. We believe
that patient safety is a critical component of quality healthcare and
encourage the CDC to actively promote this goal. |
| 04/15/2005 |
09:25 |
PU |
349 |
I |
This
is a comprehensive list and well thought through. I have the following
comments:
1) The patient safety goal speaks only to reducing medical errors. It
should also include "and decreasing transmission of infectious diseases
from health care workers". This would be consistent with studies of
improving immunization rates among health care workers against
infectious diseases such as influenza. Low vaccination coverage is not
a "medical error". And under research activities, I would recommend
adding: Develop and evaluate new strategies to improve HCW compliance
with immunization recommendations.
2) On goal I -16, I would add in after "efficient coverage" "and
control strategies". The real goal is disease control not immunization
coverage.
3) I would add several potential research activities such as:
a) Evaluate strategies to simplify the immunization schedule such as
dropping doses, changing intervals etc.
b) Evaluate prospectively and on a continuing basis the effectiveness
of vaccines and vaccine strategies
c) Develop and evaluate mathematical models to determine their
usefulness for designing and implementing disease control strategies
4) Under the 4th bullet of I-16, I would clarify that this means herd
immunity and the indirect means of protection is vaccination of the key
groups involved in transmission to reduce exposure of other groups to
the pathogen.
5) Also in I-16, the 6th bullet on waning immunity in adolescents, is
that meant to be for pertussis or for other diseases such as tetanus,
diphtheria, and meningococcal disease?
6) Under I-17, I would add a bullet - Develop and evaluate
interventions to help improve coverage in populations that currently
object to vaccines.
7) Under I-2, it would also be important to use Genomics to understand
risk groups for drug or vaccine failure, mechanisms of those failures
and strategies to overcome them.
|
| 04/15/2005 |
07:16 |
PU |
345 |
I |
New
approaches to antimicrobial resistance, broader use of genomics and
genomic approaches to public health should be included as examples of
research priorities. HIV/AIDS is underemphasized especially in health
disparities. The agenda should be more targeted and priortized to major
infectious threats. |
| 04/14/2005 |
20:50 |
PU |
343 |
I |
Starter
list not functioning
Need to further study funding for adult immunizations-- a VFC like
program.
Ethics research is missing from the portfolio to my knowledge.
Keep vaccine safety as a priority.
Consider K-awards.
Think about tailored interventions so as to make prevention in the
broader scope (including immunizations) as more feasible and
sustainable and able to reach all ethnic groups. The issue of tailored
interventions is relatively new and needs alot of study I believe.
CDC has funded a number of good studies - nice job!
|
| 04/14/2005 |
16:20 |
PU |
340 |
I |
There
needs to be more balance in ID research portfolio. In addition to epi
and lab, need more applied research, in general, and behavioral science
research in particular. Also, need more public health services
research, eg, identify gaps at state local level in surveillance
systems. |
| 04/14/2005 |
14:18 |
PU |
337 |
I |
Excellent
list although I would probably list surveillance further up. It is
great that resistance and applied genomics are listed as these are very
important areas! This workgroup did an outstanding job! Thank you!! |
| 04/14/2005 |
13:57 |
PU |
335 |
I |
Focus
on TB, AIDS, and malaria. There is no reason that as many as one-third
of the world's population has TB (including quiescent states rather
than clinically obvious infections) except the lack of political will
to eliminate TB from the globe. CDC should be educating our
policy-makers so that they make better funding choices. In terms of
AIDS, CDC staff need to forthrightly proclaim that abstinence-only
intervention programs do not work. |
| 04/14/2005 |
13:26 |
PU |
332 |
I |
Methods
for economic analysis are very important. Approaches to eliminating
health disparities in immunization should be explored. Health services
research in immunization, especially aimed at services for adolescents
and adults, is high priority. There is overlap between the patient
safety area and vaccine safety, but important to keep in mind that
patient safety focuses on elimination of medical error, which only
occasionally is a factor in vaccine safety. Epidemiology and
surveillance of vaccine-preventable diseases is a priority. Additional
behavioral and communication research needed in vaccine safety. A major
need for better understanding of the economics of the vaccine market. |
| 04/14/2005 |
12:13 |
PU |
322 |
I |
I think this should be placed within the top five priorities. |
| 04/14/2005 |
11:05 |
PU |
315 |
I |
Also need to include susceptibility and response to treatment. |
| 04/14/2005 |
10:25 |
PU |
306 |
I |
A
research agenda for biodefense vaccine safety (incl. anthrax vaccine)
was developed with input from the National Vaccine Advisory Committee,
CDC, FDA, and DoD in 2004 and a manuscript describing this agenda has
been cleared and submitted for publication.
These vaccine safety topics include studies of whether or not specific
vaccines used by the US military are related to: optic neuritis,
systemic lupus erythematosus, arthritis, and erythema multiforme. An
assessment of whether the practice of administering multiple vaccines
near-simultaneously is related to health outcomes is also included.
Second-tier study endpoints in this research agenda include
Guillain-Barre Syndrome, atrial fibrillation, diabetes mellitus in
adults, and yellow fever vaccine-related neurotropic disorders. |
| 04/14/2005 |
08:42 |
PU |
299 |
I |
I
believe that there should be a category for complementary and
alternative medicine and what it can bring to fighting infectious
diseases. For 92% of the world's HIV-infected population, access to
drugs or vaccines are not possible. However alternative treatments,
such as seaweed and spirulina, can decrease symptoms and increase
symptom-free survival before drugs are needed. This type of research
could have global impact. Algae and other indigenous treatments for HIV
are inexpensive, can be locally acceptable, and their use will support
local economies. Natural products are both good for the environment,
providing a locally available and sustainable crop, and may offer hope
for developing countries. To me, it is just not acceptable to suggest
that millions of people merely wait for drug companies to provide drugs
or die waiting. It would be good for our national image to help
identify the miriad of indigneous treatments that are already in use,
and to assist in making them more widely available. This would require
support for collecting information on these treatments and at least
preliminary testing for efficacy. |
| 04/13/2005 |
15:42 |
PU |
285 |
I |
Food-
and waterborne pathogens are not mentioned specifically. Many of these
are zoonotic agents and most are also emering pathogens. Would suggest
to add to the research activities under I13: characterization of
virulence profiles of food- and waterborne pathogens and their
correlation with disease. |
| 04/13/2005 |
13:14 |
PU |
277 |
I |
During
the past decade or so testing/screening for infectious diseases has
changed rapidly as a result of agressive marketing of nucleic acid
amplification tests (NAATs). However, many of these tests have not been
properly evaluated before marketing. Thus, it would be useful to
conduct a judicious evaluation of these NAATs by an interdisciplinary
group of statisticians, clinicians and laboratory scientsists. |
| 04/13/2005 |
10:37 |
PU |
273 |
I |
HIV
behavioral research to address the meth epidemic and its link to sexual
risk behavior among men who have sex with men; the community is ripe
and asking for more CDC work and expertise in this area; address the
link between subtance use and sexual risk in general for MSM, as well
as just meth use |
| 04/13/2005 |
09:59 |
PU |
271 |
I |
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. This will be very
critical in our fight against pneumococcal disease. Already, there is
significant replacement disease following introduction of the very
effective 7 valent conjugate vaccine. Just note this: The replacement
disease is relatively low now, but penicillin resistance was rare 25
years ago. Where there is a biological means to escape selection, the
pneumococci will adapt. Formulating more effective pneumococcal
vaccines depend upon our continuing serotype and pneumococcal genetic
surveillance. Pneumococcal genetic surveillance, allows us to
understand how strains change and where they are coming from in this
continuing "arms race". |
| 04/13/2005 |
09:35 |
PU |
269 |
I |
Will
these categories be furthered subdivided by types of disease? For
example, will "Infectious Disease Surveillance and Response" be broken
down into types of infectious disease agents (i.e. viruses, bacterial,
rickettsial, parasitic, etc.). All the categories mentioning
"Infectious Disease" seem very general. |
| 04/12/2005 |
14:51 |
PU |
264 |
I |
•
Infectious Disease: Consider effectiveness of water fluoridation,
dental sealants, and caries vaccine in reducing disparities in at-risk
populations. Investigate the feasibility and cost-effectiveness of
integrating rapid-HIV testing into dental clinics. Consider developing
a resource optimization model that could be used to identify the most
effective combination of prevention interventions within a given budget
situation. |
| 04/11/2005 |
11:15 |
PU |
255 |
I |
I
cannot emphasize enough how important it is for this agency to focus on
hand hygiene research if it is to remain the leader in infectious
disease research. Hand hygiene affects all infectious diseases, and
contributes to the overall health of individuals. There are many gaps
in the research, and CDC need to make hand hygiene a priority now, but
specifically including it in this list, and dedicating funds to it -
which it has not done in the past. We have no experts on hand hygiene
for the general public, nor hand hygiene a funded research topic
currently. It needs to become a priority for CDC. |
| 04/11/2005 |
09:59 |
OH |
251 |
I |
see general discussion comment below |
| 04/11/2005 |
09:30 |
PU |
243 |
I |
under
either or both the topics of "economic analyses of infectious disease"
and "infectious disease diagnostic methods," please include the need to
conduct cost-effectiveness analyses of the various diagnostic methods
under "health disparities" please include in the description of
structural factors "economic" factors |
| 04/11/2005 |
09:26 |
PU |
242 |
I |
Please
include a definition of populations to be included under the topic of
health disparities, otherwise it may succumb to being defined soley by
race/ethnicity.
The Healthy People 2010 plan for eliminating health disparities
discribed the following populations as a minimum for data collection of
health disparities. Here are the HP2010 populations:
* race/ethnicity (American Indian/Alaska Native, Asian/Pacific
Islander, Black/African American, White, Hispanic/Latino, Not
Hispanic/Latino)
* gender * SES: family income level (poor, near poor, middle/high
income), and/or education (less than high school, high school grad, at
least some college)
these populations when they are at risk:
* geographic (urban, rural)
* health insurance status (private, public, none)
* disability (disabilities, not)
* sexual orientation
* select populations (age, school grades, selected medical conditions) |
| 04/11/2005 |
07:59 |
PU |
239 |
I |
Could
development and evaluation of new vaccine candidates be considered part
of the research activities for infectious diseases? Also, very few
activities were targeted to the study of therapies/vaccine/diagnosis
and surveillance of HIV/AIDS. |
| 04/08/2005 |
13:56 |
PU |
233 |
I |
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 |
| 04/08/2005 |
08:45 |
PU |
232 |
I |
This is something that seems to have a need to be connected somewhat to the 1st category, that of preparedness. |
| 04/07/2005 |
15:59 |
PU |
224 |
I |
I9
& I11 - Define populations at risk that links disparities based on
socio-demographic, behavioral and attitudinal characteristics. Develop
tools, materials that respond to intersections of health
disparity-based identities. |
| 04/07/2005 |
13:40 |
PU |
216 |
I |
I
read the Infectious Diseases Workgroup list of research priorities.
There is little in the entire list of categories that will gladden the
heart of medical microbiologists, or molecular biologists working in
infectious diseases. Although Genomics has a prominent category, a
closer reading reveals this applies to Human Genomics, and not
Microbial Genomics. This at a time when microbial genome sequences are
now becoming generally available for further study. Although
Diagnostics is invoked as a "mantra" in item 10, it is unclear what
type of diagnostics is meant. Is it the development of fundamental
knowledge of microbes that might lead to novel tests, or does it mean
development of tests to the point of clinical utility, which brings the
CDC into competition with the companies with large staffs, like Abbott
Laboratories, who have this as their role and purpose. Does it mean
concentrating on diseases of low prevalence which do not attract the
attention of commercial companies? I have searched the research
priorities to find some way to identify one of the strengths of CDC
that distinguishes it from NIH intra- and extramural research: the
knowledge of population genetics of microbes that is exploited to
develop tests to trace their transmission in the hospital and
community: simply put: molecular epidemiology. Is this topic meant to
be covered in item 12? If so parsing that category and its
subcategories fails to delineate this type of research. Many of the
goals are not laboratory based. Goal 3, goal 5, Goal 7, goal 8, goal 9,
goal 11, goal 14, goal 16. Whereas such goals are laudable and can meet
the definition of research, one is left with the impression that the
laboratory is a mere adjunct to the data gathering and surveillance
activities. I do not believe this is intentional but perhaps reflects
the fact that the strategists are quite removed from the laboratory and
are not stakeholders in the laboratory. One merely has to look at the
infrastructure improvements in laboratories that are now well underway
and wonder how it will be able to recruit and retain staff who read
this type of Infectious Diseases Priorities. How will newcomers and ,
for that matter, the thin red line of laboratory researchers here view
their future in the organization? |
| 04/07/2005 |
11:24 |
PU |
214 |
I |
Incidence
and other studies related to HIV Counseling, Testing and Referral
should include CCR5 Delta 32 genotyping to exclude those individuals
who are not at risk of HIV infection. These individuals should be
excluded from studies to improve the accuracy of the denominator value
in risk statistics. Many studies have demonstrated that individuals
carrying a homozygous deleted form of the Delta 32 gene were protected
against HIV-1 transmission. The CCR5 heterozygous genotype may confer
partial protection against HIV-1 infection. Another consideration is
that Delta 32 is rare in people of African and Asian descent .
Therefore, it seems plausible that interactions between genetic
susceptibility, social and behavioral factors may contribute to the
rapid heterosexual spread of HIV-1 among individuals of African, Asian
or non-Eurpean ancestry.
Submitted by:
Evelyn McCarley-Foxworth (contractor)
PERB/ Couseling and Testing |
| 04/07/2005 |
10:39 |
PU |
212 |
I |
In
Section I 9, CDC should sponsor research on the possible infectious
etiology of Crohn's diseases, one of the two inflamatory bowel
diseases. There is evidence that Crohn's may be caused by Mycobacterium
paratuberculosis, but the evidence is incomplete. There are claims
(poorly supported) that the organism is transmitted in milk, even
pasteurized milk. This makes it a potential public health problem that
would be preventable. Better research is needed in this arena. I would
be happy to provide more information, if needed.
Myron G. Schultz |
| 04/07/2005 |
10:09 |
PU |
209 |
I |
Consider
serious etiology research for diseases that are ruled out, based on
national diagnostic criteria. e.g. What is the actual agent causing
thousands of cases of disease that "look like" Lyme disease, especially
in areas where Lyme disease is not known to be endemic. |
| 04/07/2005 |
09:19 |
PU |
201 |
I |
We
need better resolution on defining species and subspecies and varieties
of pathogenic bacteria and viruses. We need references which are
defined in all aspects including antibiotic susceptibility in a readily
accessible format. Untill we can absolutely describe organisms, we are
unable to assess full health impact of lesser yet persistant pathogens. |
| 04/07/2005 |
08:45 |
PU |
198 |
I |
CDC
should continue to participate in pathogen discovery and
characterization (once referred to as emerging infectious diseases).
This can only be done by trying to maintain an infrastructure that has
expertise in a wide variety of microbial systems including those that
may not be percieved as front row pathogens. CDC history is rich in
identification/discovery of important agents (e.g.,Legionella) by
specialists who routinely work with disease groups with lesser public
visibility. |
| 04/07/2005 |
06:45 |
PU |
190 |
I |
All
very important. Influenza, for example, is an established infectious
disease, yet every year, recombination results in new strains. To drop
the ball here would be unwise. |
| 04/06/2005 |
17:43 |
PU |
186 |
I |
Where
does research on i) the prevention of complications from infectious
diseases and ii) understanding the clinical presentation of infections
and their complications fall? These research activities are critical to
the the understanding and recognition of infectious diseases and the
many facets of their prevention. |
| 04/06/2005 |
08:53 |
DC |
179 |
I |
Before
writing guidelines on respiratory protection and the need for N95
respirators to control transmission of TB and other infectious agents,
research is needed on the relative role and effectiveness of masks and
N95 respirators. Are N95 respirators necessary to control transmission
of TB and, if so, is annual fit-testing needed? Studies needed to
define importance of the hierarchy of controls in preventing healthcare
associated transmission of TB and other infectious agents potentially
transmitted via the airborne route: administrative, environmental and
PPEs.
Need to determine the role of patient characteristics,
procedure-related events and environmental sources of infectious agents
in airborne disease transmission. |
| 04/05/2005 |
23:13 |
PU |
175 |
I |
This will be very important in the years to come |
| 04/05/2005 |
19:03 |
PU |
173 |
I |
With
the increasing number of vaccines available for children, it is
becoming more important to examine the interactions between different
vaccines given at the same time as well as the safety of the various
combination vaccines
|
| 04/03/2005 |
21:43 |
PU |
144 |
I |
research
the supression of the immune system from alcohol use, marijuana use and
other drug use, including the misuse of perscription drugs.
does infectious diseases spread more quickly in the AOD using
population? |
| 04/01/2005 |
08:20 |
DC |
142 |
I |
Complete
a valid study on the need or not for fit-testing of N-95 respirators.
Develop a controlled study of resistant organisms and antibiotic use in
an environment that allows Pharmaceutical companies to educate
physicians and one that requires medical professionals to do the
research and education. |
| 03/30/2005 |
10:37 |
DC |
131 |
I |
Would aslo like focus on biologic terrorism
Development of standards or guidelines that can be referred to when making policy. |
| 03/30/2005 |
08:50 |
DC |
123 |
I |
Development of new and more reliable testing for TB. |
| 03/30/2005 |
08:48 |
OH |
121 |
I |
A
particular emphasis needs to be placed on maintaining quality HIV
prevention programs in the face of political resistance. Effective,
evidence-based programs are often undermined by a vocal minority that
politicize public health issues. A recent example is elimination of the
"Programs tha t Work" program supported by DASH. The research and
service initiatives supports programs that work should be reinstated. |
| 03/29/2005 |
14:18 |
OH |
117 |
I |
Oral
health has implications relevant to all the chronic disease programs
established by the National Center for Chronic Disease Prevention and
Health Promotion (NCCDPHP), including cancer control, diabetes, healthy
aging, healthy youth, heart disease and stroke, nutrition, safe
motherhood, and tobacco. Additionally, several reports have provided
evidence for the potential correlation between oral diseases such as
periodontal diseases, and systemic disorders such as cardiovascular
disease and adverse pregnancy outcomes. For these reasons, the topic of
the role that oral health has on an individual’s overall health should
be added to its research agenda. The feasibility, efficacy and
cost-effectiveness of integrating rapid HIV –testing in dental clinics
were highlighted in the CDC’s Division of Oral Health Research
Opportunities. This should be expanded to include additional infectious
diseases such as the hepatitis B and C viruses, oral diseases such as
caries susceptibly, periodontal disease and oral cancer, and systemic
disease such as diabetes and cancer. Thus, this topic should be
expanded to include research on multiple forms of salivary diagnostics
as well as potential applications, practice implications, economics,
and liability issues. In line with this, research is needed regarding
the role of dentistry in the screening of systemic disease and the
development of guidelines for referral to medical specialties for
corresponding diagnosis and treatment. |
| 03/29/2005 |
10:57 |
DC |
114 |
I |
TB....this
is still a very hot topic. We need to priortize research on the
relative role and effectiveness of respiratory protection and the need
for fit-testing in the control of TB and other various infectious
agents. With the continuing decrease in healthcare resources, both
staffing and money, we need to determine how best to spend those
resources. It is important to make the best decisions that will provide
the best protection economically. All research needs to include
scientific data that proves beyond a reasonable doubt that taking this
action will provide higher quality of care to the patient and protect
our staff at the same time. This would include issues such as
documented proof that use of fit tested respirators provide less
seroconversions that use of a surgical mask. I realize that the
perception is that obviously a fit tested respirator will provide
better protection but I have never seen data that has documented this
fact. |
| 03/29/2005 |
09:08 |
DC |
106 |
I |
Need
a meta analysis (or other study) of all nosocomial tuberculosis
transmissions (ever) to help dispel the myth that fit testing a paper
"respirator" is necessary. Since no transmission has ever occurred with
a well fitting paper mask and other environmental controls in place,
this would be a great efficiency booster for ICPs. |
| 03/28/2005 |
13:29 |
DC |
102 |
I |
We
are also very concerned about influenza, RSV, and other respiratory
diseases that pose a serious risk to some children (and sometimes to
adults), in addition to some of the emerging conditions (e.g. avian
influenza). |
| 03/28/2005 |
13:20 |
DC |
95 |
I |
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. 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. Health
outcome and cost-benefit studies on the use of personal protective
equipment: types of respiratory protection, frequency and utility of
fit-testing. The relative role of patient characteristics,
procedure-related events and environmental sources of infectious agents
in airborne disease transmission
|
| 03/28/2005 |
13:12 |
DC |
94 |
I |
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.
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. Health
outcome and cost-benefit studies on the use of personal protective
equipment: types of respiratory protection, frequency and utility of
fit-testing. The relative role of patient characteristics,
procedure-related events and environmental sources of infectious agents
in airborne disease transmission The actual scientific rationale for
using respirators for the control of transmission of disease needs to
be elucidated- when concept was first introduced (for MTB) there was
absoulutely no evidence to support using respirators. This one concept
has caused a great deal of resources to be used that could have been
directed towards activities that are scientifically valid &
actually work.
|
| 03/28/2005 |
12:43 |
DC |
92 |
I |
mycobacterium para tubreculosis & link to Crohns & IBS |
| 03/28/2005 |
12:40 |
DC |
90 |
I |
Would like to see more research and promotion of vaccine preventable diseases. |
| 03/28/2005 |
11:33 |
DC |
78 |
I |
Encourage
colleges and universities to offer courses and degrees in Occupational
Health, Infection Control and Epidemiology of new and emerging
diseases. |
| 03/28/2005 |
10:19 |
DC |
71 |
I |
Research in to the effectiveness of mask fit-testing in the control of
transmission of various infectious agents. Pulmonary tuberculosis being
the most frequently referenced disease. Cost effectiveness use of
personal protective equipment vs transmission.
|
| 03/28/2005 |
09:17 |
DC |
65 |
I |
Outcome
research (transmission studies) to define the relativeimportance 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.
The relative role of patient characteristics, procedure-related events
and environmental sources of infectious agents in airborne disease
transmission
|
| 03/28/2005 |
08:41 |
DC |
61 |
I |
Research
to show if pulmonary Mycobacterium tb is transmitted to care givers
wearing a well fitted submicron (surgical, non-respirator) mask. Would
like to decrease the time and money taken to fit test respirator use in
healthcare givers in the hospital.....need the time and money for
issues much more practical, especially since unable to find any good
research showing surgical masks don't work. (Or at least research to
show that disposable N-95 respirators do or don't protect healthcare
givers from tb, if they are snug on the face without gaps (without
being fit tested). |
| 03/28/2005 |
08:10 |
DC |
59 |
I |
Although
it is extrememly important to understand the workings of pathogens on a
molecular level, I think that more emphasis should be placed on
prevention of transmission of infectious organisms and development of
vaccines. |
| 03/27/2005 |
16:24 |
DC |
55 |
I |
How
about more research on true primary prevention for non-sexually
transmitted (respiratory and GI) diseases as they seem to be the
largest cause of mortality and "cost" to the health care system. Also
CDC should use Health Promotion targeting the public to disseminate the
messages of the research they fund |
| 03/25/2005 |
13:08 |
DC |
51 |
I |
Vaccine development is of the upmost importance--along with chemoprophylaxis. |
| 03/22/2005 |
13:52 |
WA |
38 |
I |
Explain
to the public why the CDC did not educate the public on the HCV
epidemic after learning of it's wide spread potential and the largest
population infected were the blood transfused. Also explain to the
public why the CDC did not establish an early warning system after the
HIV/AIDS epidemic was funded by congress so that this would never
happen again or if it happened again, through the early warning system
we could educate the public and slow the spread and/or identify the
population potentially infected? Governments failure has cost lives and
we still have no "honest" public education on this issue. Instead we do
have a CDC integrated plan that would conveniently integrate HCV into
HIV/AIDS programs therefore again, adding salt to the wound; misleading
the public as to their real risk factors (either a drug abuser or MSM)
and turn away any potential questioning of the governments role in the
spread of this epidemic. |
| 03/15/2005 |
13:55 |
WA |
26 |
I |
Invited participant for this breakout group |
| 03/15/2005 |
00:18 |
WA |
25 |
I |
Vaccines should be developed to fight new epidemics as well as we need to look at distribution, cost, supply. |
| 03/11/2005 |
07:02 |
GA |
18 |
I |
Sexual behavior research |
| 03/04/2005 |
23:04 |
GA |
12 |
I |
I
would like to encourage the expansion of topical microbicide research.
It is imperative that we increase the funding for microbicide clinical
trials until an effective and safe microbicide is available to the
public. Specifically, women need options they can use to protect
themselves when their partners don’t use condoms – options they can
control and use without their partner’s participation, if necessary.
Microbicides are being designed to fill that niche. A safe, effective
microbicide will allow women to take action to protect themselves
without having to rely on their partners for protection. The
possibility of a gel or crčme that gave women that power seems like a
real cause for hope. Such a break-through could actually change the
equation of risk and substantially reduce the numbers of women becoming
infected with HIV. Microbicides aren’t cheap to develop and more public
funding is urgently needed to keep the research to find a safe,
effective microbicide moving as quickly as possible.
Please give thoughtful consideration to this issue.
Sincerely,
Terri L. Wilder, LMSW
Coordiantor
Georgia Campaign for Microbicides
|
| 02/25/2005 |
08:43 |
GA |
7 |
I |
Development of improved diagnostic tools for detection of latent TB infection and active TB disease.
Development of antibiotics for drug resistant TB strains.
Development of a TB vaccine.
|
Back
to Top
|
| Date |
Time |
Type |
ID |
Group |
Comment
|
| 04/20/2005 |
10:33 |
PU |
474 |
X |
1.
We need to combine all the health surveys and other information to see
the entire picture of the Health Status of the US population. To
accomplish this complex task, we can develpo Health Index of the US
population by either modelling or weighted sum methods. 2. Analytical
method for the complex sample survey data is needed because the
conventional method is not suitable for the specific nature of CDC data
sets
Nonresponse is a serious problem for NCHS survey such as National
Health and Nutrition Examination Survey (30-40 percent nonrespomnses).
To do better analysis of the data, we need to understand non-responses
and data analysis should incorporate them. |
| 04/20/2005 |
07:18 |
PU |
472 |
X |
CDC
is committed to supporting and developing evidence-based public health
interventions, yet many effective interventions implemented in
communities do not have formal evaluations in the published literature.
A promising area of CDC research investment is in supporting the formal
evaluations of community-originated public health intervention efforts.
That is, CDC would offer funding and technical assistance to programs
already being implemented that feel they have promise and would like to
undertake a formal evaluation that could be submitted for publication.
By increasing the scope and range of evidence that is represented in
the peer-reviewed literature, we increase our effectiveness as a public
health agency engaged in evidence-based intervention.
In support of this proposal, please see the following document that was
developed by the CDC's Measures of Racism Working Group:
1. Provide a summary statement of your research idea or theme (1
sentence or phrase)
Formal evaluation of community-originated interventions
2. Provide details/examples of idea (1-2 sentences) CDC will invite
requests for funding and technical assistance from community-based
organizations to evaluate intervention strategies that have originated
and are already being implemented in communities.
3. Describe how this theme addresses or relates to the four criteria:
a) Public health need/importance of problem
In the 2004 pilot of the CDC Goals Management process, the goals
management pilot teams were asked to evaluate intervention strategies
and provide evidence-based guidance to CDC on best investments for
public health impact. During that process, the limitations of published
reviews such as the Community Guide to Preventive Services became
clear:
• Many promising public health interventions are never formally
evaluated
• Many evaluations that are conducted are never published
• Formal reviews of published evaluations deal with dated intervention
strategies because of the delays inherent in publication and then in
the review process
If CDC wants to invest its resources in the best available intervention
strategies, it will need to broaden the pool of candidate strategies
beyond those currently identified in formal reviews of published
evaluations.
Increasing the number and range of promising public health programs
that are formally evaluated will improve CDC’s ability to make the best
decisions about how to invest public health effort and dollars.
b) Relevance to reducing health disparities
The lack of formal evaluation of promising community-originated
intervention strategies is especially true in the communities with the
poorest health outcomes. These communities are often strapped for
resources and access to evaluation expertise. Limited intervention
resources are usually devoted entirely to program, with no reserve set
aside for evaluation. Interactions with academic institutions are often
limited or laden with a history of being disrespected, and evaluation
expertise is often not nurtured within these communities.
Strategies for addressing the causes and manifestations of health
disparities are being tried everyday in affected communities, and CDC
can help identify the best of these.
c) Potential for broad impact
CDC investment of resources and expertise for formal evaluation of
ongoing community-originated interventions will allow the innovative
strategies currently being implemented in these communities to be
brought to the table and potentially taken to scale.
d) Relevance to CDC mission and health protection goals
CDC has a responsibility to make the best use of our public health
dollars. Broadening the pool of formally-evaluated intervention
strategies will improve CDC effectiveness in addressing all of our
health protection goals.
|
| 04/20/2005 |
07:06 |
PU |
471 |
X |
We
need add a research priority to the Cross-Cutting Research agenda
entitled "Social Determinants of Health". This area would include
research efforts to identify and intervene on the fundamental causes of
behavioral and health outcome disparities.
In particular, research would: Examine differences in the distributions
of exposures, opportunities, and outcomes by “race” and socioeconomic
status. Include measures of racial climate in surveillance systems.
Develop disparity impact assessments tools to enable disparity impact
statements for all newly proposed policy and programs (at federal,
state, and local levels). Mandate the collection of socioeconomic data
with all federally-supported data collection. Develop measures of
racial climate, institutionalized racism, personally-mediated racism,
and internalized racism, including qualitative measures of structures,
policies, practices, and norms.
In support of adding "Social Determinants of Health" as a research
priority, see the following language excerpted from the July 2004 final
report of the Public Health Research Implementation Team chaired by
Tanja Popovic as part of the CDC's Futures Initiative:
Recommendations:
Conduct surveillance to describe and monitor the health burden of SDOH
• Assess CDC surveillance systems to evaluate how they currently
capture social determinants of health, and recommend modifications or
additional measures as needed • Conduct surveillance of neighborhood
and community contexts, beginning in 5 major cities • Develop new
measures of social context for use in surveillance
• Review and develop social health indices to summarize population
health across communities, states, and the nation and to track changes
over time
Conduct epidemiologic studies and advance methods to identify the
health impacts of SDOH • Employ new methods, such as life course
epidemiology and multilevel analysis, to elucidate the relationships
between social determinants and health outcomes • Develop measures of
assets and social support structures in communities to identify
behavioral, cultural, and social factors that promote health • Train
investigators to ask new questions about how racism, socioeconomic
status, and other stress-inducing processes affect health, especially
in vulnerable populations
• Train CDC scientists on the health and human rights frameworks that
have been adopted internationally; provide guidance for understanding
how CDC research and programs fit into a larger health and human rights
framework
Conduct SDOH intervention and translational research • Review current
intramural and extramural social determinants of health intervention
research activities; identify gaps and make recommendations for future
research • Identify current behavioral and biomedical interventions
that could be expanded to address social determinants of health in
order to increase effectiveness
• Develop incentives to support cross-CDC and cross-Federal Agencies
collaboration on social determinants of health research
• Develop innovative evaluation and program tools that incorporate
social determinants of health approaches
• Develop new methods, such as Health Impact Assessment, to evaluate
the public health impact of social interventions (for example, housing
or job training programs)
• Expand opportunities to work with communities to capture local
knowledge and build capacity to address social factors that influence
health
Develop structures and partnerships to integrate SDOH into PH research
and practice
• Establish a central social determinants of health hub in the Office
of Strategy and Innovation or the Office of the Chief of Science to
guide CDC social determinants of health activities
• Establish social determinants of health teams in 5-7 CIOs and/or
Coordinating Centers, affiliated with the Associate Directors of
Science and linked to the central social determinants of health hub
• Collaborate with the NIH Office of Behavioral and Social Sciences
Research to establish a continuum of social determinants of health
etiologic and intervention research
• Develop social determinants of health and multidisciplinary training
opportunities and programs within the Office of Human Capital and
Professional Development; explore potential collaboration with the NIH
Office of Behavioral and Social Sciences Research
• Establish extramural research programs that are consistent with
intramural social determinants of health research goals and activities
|
| 04/19/2005 |
22:43 |
PU |
470 |
X |
X11
- Important topic. I suggest defining "Public Health Workforce" broadly
to include healthcare and public health practitioners with lower levels
of training, i.e., medical assistants/techs, and other allied medical
services and therapies who can inturn help to educate the public and
impact public health. |
| 04/19/2005 |
22:38 |
PU |
469 |
X |
X5
- People with Disabilities are a population frequently overlooked by
Public Healt. Although gaps in surveillance of people with disabilities
are identified in Healthy People 2010 and other sources, CDC has an
opportunity to lead the nation in adequately addressing the special
access to public health, stigma and lack of adequate knowledge by
health care providers and public health, which further compounds and
compromises their health. Rates of disability are highest among Native
Americans, and obesity rates are high among people with disabilities.
CDC needs to do more research in this area. |
| 04/19/2005 |
17:43 |
PU |
465 |
X |
For
the last two years I have explored published research related to
strokes and discussed potential collaborations to address some of the
issues associated with the increasing burden of stroke and its
long-term consequences on the population. Based on my research and
discussions with potential collaborators, there is a tremendous
opportunity to develop a laboratory research focus on stroke.
We have done some preliminary work to develop a proposal for a project
to validate and implement quantitative methods for measuring and
profiling proteins associated with strokes, identified methods and
technology to be validated, and located sources of samples for a study.
What we have not been able to identify is a relatively small amount of
funding to support the project.
My reason for including this suggestion under cross-cutting research is
that the technology we propose is very sensitive and versatile. It has
the capacity to identify, measure, and monitor proteins and peptides
for applications related to chronic diseases and chemical and
biological exposures. This technology provides a broader (lower
resolution) view, rather than a narrow focus and is complementary to
the higher resolution technologies that we are currently using. My
concern is that we are passing up the opportunity to look at the forest
because we are so focused on the trees. I would be delighted to discuss
this in more detail.
Mary K. Robinson, Ph.D.
Health Scientist
Division of Laboratory Sciences
National Center for Environmental Health
Centers for Disease Control and Prevention
Voice: 770-488-4208
Fax: 770-488-4192
E-mail: mkr1@cdc.gov
|
| 04/19/2005 |
17:26 |
PU |
463 |
X |
X17,
Ethics in Public Health: this area is really important. Public health
isn't very reflexive, and doesn't tend to recognize the ways in which
it can conflict with the values of human rights and the principles of
research ethics. Public health needs to think more carefully about when
and how it is appropriate to engage in what might otherwise be called
social control or paternalism, in the name of the public good. We need
to be good stewards of our knowledge and methods, and their uses. |
| 04/19/2005 |
16:13 |
PU |
457 |
X |
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 |
X |
Comment
1: Suggested bullet for "Examples or research activities" for item X-12
(Economics and Public Health): "Developing models to value unintended
consequences (positive or negative) that accompany large-scale public
health interventions." Explanation: Some public health interventions
are designed to prevent a disease with modest burden. The intervention
may be cost-beneficial per se, but the almost inevitable unintended
consequence could introduce costs that vastly outweigh that burden.
Perhaps certain kinds of intervention should not be applied for
diseases that have less than a threashold burden, esp. if the
intervention is not voluntary for the population. Comment 2: Change
first bullet in X-12: "Develop methods to produce currently unknown
values for various economic measures of health burden and well-being,
INCLUDING COSTS TO THE PUBLIC HEALTH SYSTEM" Explanation: we lack data
on costs of outbreak control, etc.
Comment 3: Also for X-12 (I have no suggested wording for this bullet):
CDC should conduct research - and publish results - relating to the
value of outbreak investigation and control to society. Explanation:
The SARS epidemic cost the global economy $10s of billions, and
CDC/WHO/Others identified risk factors to reassure commerce and
ultimately helped control the scope of the epidemic. How much money did
CDC save the global economy? |
| 04/19/2005 |
15:43 |
PU |
453 |
X |
We
need better standards for developing estimates of cost of illness (COI)
for various chronic and other diseases. Right now the field is a mess.
Also, how about more research on how to reduce or eliminate
sociodemographic disparities? Everyone trots out data documenting the
disparities, but no one seems to take on the harder issue of how to
reduce them. I believe the underlying problems are similar no matter
what the disease, so an addvance in any one area may help everyone. |
| 04/19/2005 |
15:31 |
PU |
452 |
X |
Way too much information squeezed into this area. Who would want to read this? Cut it down, make it simple.
Do we need this group along with all the others? |
| 04/19/2005 |
14:21 |
PU |
447 |
X |
New
theme
There is a need for an additional cross-cutting research theme
specifically focused on development and validation of health-related
quality of life methods. This theme is closely related to the CDC
Mission "to promote health and quality of life..." as well as to the
Healthy People 2010 goals to "increase the quality and years of healthy
life" and "eliminate health disparities". This area of study is very
important to the public as well as to state and community leaders and
has considerable potential value to CDC research and intervention
programs in all other research theme groups. Yet it has no clear
funding stream and it is not adequately addressed or emphasized by the
current research themes. A suggested Research Theme Title and
Decsription and Examples of Research Activities are as follows...
Health-Related Quality of Life--
Develop and evaluate survey-based methods for assessing health-related
quality of life--defined as perceived physical and mental health over
time--and for tracking these perceptions in state and community
populations to identify potentially unmet health needs and disparities,
evaluate the effects of health policies and programs, and guide the
effective allocation of public health resources. Examples of Research
Activities--
+Develop and validate brief sets of health-related quality of life
measures for use in population surveys and prevention research.
+ Develop valid methods for assessing health-related quality of life in
multiple settings (e.g., homeless shelters, clinics, and nursing homes)
and populations (e.g., new immigrants and persons with limited reading
skills) +Study factors relating to worsening and improving trends in
national, state and community health-related quality of life.
Conduct applied research on the use of population health-related
quality of life data by states and communities in health
decision-making and policy. Theme X14
In the description of X14 add "assess and" after "better" and add "in
populations" after "mental health". Add the following example as
well...
+Develop and validate brief measures of depression, anxiety, and other
common mental health conditions and symptoms (in collaboration with
mental health agencies) for use in population surveys and prevention
research. |
| 04/19/2005 |
14:20 |
PU |
445 |
X |
It
appears that CDC is starting the recognize and bring to focus
complimentary and alternative medicine practices. In a presentation
scheduled for May 23rd, researchers will present how Yoga breathing
exercises (technical term: Pranayama) are effective for multiple types
of behavioral and health outcomes that are priority for CDC.
Research that focuses on self-management of chronic diseases may
benefit from learning about alternative practices from the East. |
| 04/19/2005 |
13:25 |
PU |
439 |
X |
X7.
Identification of barriers to health promotion/disease prevention
interventions to include mental illness (depression/anxiety, etc).
X14. Mental Health Promotion and Illness Prevention are important both
in their own right (which this goal addresses) but also with respect to
many of our existing areas of focus. As written, the examples do not
include ways that mental health promotion and mental illness prevention
are important as part of overall health and well being. For example:
Addressing the impact of depression on risk behaviors like smoking,
physical inactivity and poor nutrition. Or the need to attend to mental
health of people diagnosed with chronic diseases like HIV/AIDS,
diabetes, heart disease etc. Also community resilience and terrorism (a
psychological target of attack). Or how can you motivate someone who is
depressed and obese to exercise which would have impact on both obesity
and mood. Where will this research be done if not here?
This cross cutting topic is VERY important but as currently framed is
less cross cutting and more focused. I think we could have a role in
both but believe our impact would be greater if we worked on this in
MANY of our current areas of focus. |
| 04/19/2005 |
12:27 |
PU |
437 |
X |
theme
X 12 - This is vitally important. We need to know what it is costing us
to not promote health and to spend so much on medical care. What if we
spent 50% on prevention and 50% on care. |
| 04/19/2005 |
12:25 |
PU |
436 |
X |
Theme
X8 -
What is impact on transportation system on access to health care and
healthy food. What is impact of car dominated transportation on health
of those who can't drive (blind, elderly, disabled, seizure disorder). |
| 04/19/2005 |
11:56 |
PU |
433 |
X |
A major area of needed research is in the financing of public health
agencies. LOCAL capacity building is currently the prime imperative for
the nation's public health infrastructure. Nevertheless, the local tax
base in many places simply is not adequate to support necessary
functions and essential serivces. Innovation is needed to properly
allocate financing among local, state, and federal sources as well as
to private-sector entities. Models need to be developed that provide
government with tools to predict staffing levels, operating costs, and
capital investments. |
| 04/19/2005 |
11:18 |
PU |
430 |
X |
I
would think that these areas could be better coordinated with IOM
recommendations for public health prevention. CDC should also have a
better balance between risk, prevalence, and funding in its activities.
Things that NIH is already doing should be left to the bigger pockets
of NIH. All of the moves to make CDC more like NIH should be
re-examined. We used to be looked at as innovators within public
health. Now we are maintainers of the status quo, generators of more
bureaucracy, and supportive of a political administration that
continually undermines the public health. Lastly, I think CDC should
have a serious examination of using this business model of
re-organization. The business model has destroyed effective health care
in the US - people are sicker and care is more expensive and less
personal. This model is also starting to take down public health. CDC
is a worse place to work and we are less responsive to the wholistic
aspects of population health because of it. |
| 04/19/2005 |
10:23 |
PU |
423 |
X |
I
recommend that the research activities for X.7 include: Identify
risk/benefit perceptions and barriers to behavior change of population
segments as the basis for salient messages.
I recommend that Theme X.10 be rewritten to state "... to disseminate,
implement, and maintain effective interventions and programs."
I recommend that the first research activity for X.10 include
"implementation, adaptation, and maintenance" of effective
interventions.
I oppose research theme X.15 on the grounds of privacy violation,
stigma creation, and negative impact on persons' insurability. |
| 04/19/2005 |
09:46 |
PU |
421 |
X |
Thanks
for this list; lots of important topics that don't always have a clear
"home". Particularly pleased to see and want to emphasize the
importance of research related to workforce and career development
issues. Although HRSA has a role in this arena, it is primarily
clinical, rather than public health, in nature. Another topic to add
relates to (public) health systems research -- for example, how do
organizational structures, relationships, etc., influence public health
impact?
Thanks for the opportunity to comment.
|
| 04/19/2005 |
06:48 |
PU |
417 |
X |
Theme
ID X19 Research theme title and description
Determinants of demand for preventive services Identify socio-economic,
organizational and institutional factors that effect individual demand
for preventive services
Examples of research activities
• Investigate variations in individual demand for preventive services
by the type of health insurance coverage, exposure to worksite health
promotion programs, health risk knowledge and attitudes about health •
Investigate the effects of consumer-oriented approaches to management
of health care costs (high-deductible health savings accounts) on
availability and use of preventive services
|
| 04/18/2005 |
16:26 |
PU |
414 |
X |
Comprehensive
program evaluation: if state health programs are making a difference.
Doing more work with states, communities-"trench-work" to find out what
is really happening, what is working, etc. |
| 04/18/2005 |
15:37 |
PU |
411 |
X |
This
area relates better to gaps in the health promotion area. However more
is needed in research related to: the need for more research in social
ecological models, implementation of transdisciplinary intervention,
methods for engaging communities, advisory boards, and tribal
leadership, trans-disease/risk factor intervention strategies for
policy and systems change, and rapid translation/dissemination of
research to practice. The bottom line suggestion is we need research to
solve problems (the "how to") rather than just describing problems. |
| 04/18/2005 |
15:18 |
PU |
409 |
X |
I
believe the title "Cross-cutting research" should be revisited. Rather,
the important issues that are addressed here are more reflective of
"Foundational Research". I also believe that the public health systems
research concepts included here - such as exploring the public health
infrastructure and state and local public health agency structures and
roles, public health workforce, etc. - are so critical that they should
be included in their own category. Without the strong organizational
and workforce components required to actually undertake public health,
the programmatic activities reflected in the other research categories
would suffer. |
| 04/18/2005 |
14:09 |
PU |
405 |
X |
I
think it is essential to have a robust cross-cutting research agenda to
address such issues as the public health workforce. With the looming
crisis of the aging and changing workforce in all the public health
institutions throughout the country, we will be challenged to maintain
a state of preparedness in any category, regardless of the level of the
science. We must do research in the basic infrastructure issues and
have the real hard data for the difficult competition for scarce
resources. Additionally, all funding sources now want to know the
impact of their training dollars. Without good evaluation, it will be
difficult to show the impact of those training dollars which will make
it more difficult for legislators to advocate for essential training. |
| 04/18/2005 |
13:47 |
PU |
402 |
X |
Once
again, there appears to be redundancy in some of the goals from this
area that have been covered in other areas - Disease, Injury,
Disability, and Exposure surveillance; Eliminating Health Disparities;
Health Education, Communication and Marketing. Despite the
"Cross-cutting" in the title of this theme, it appears to once again
focus of items that are covered in other groups. |
| 04/18/2005 |
13:14 |
PU |
397 |
X |
The
starter list is completely inadequate with regards to including
foundational research of systems-wide infrastructure or capacity for
local and state public health. CDC has placed considerable emphasis on
accountability, yet no mention of performance standards, accreditation,
or other standards setting processes are listed. This area of research
should be the highest priority at CDC, simply because without adequate
knowledge of what's out there and how to organize, structure and
finance the PH system in order to maximize it's impact, then all the
research dollars spent on other areas is wasted. You need a separate
category just for systems research - particularly the local and state
agency component. Some suggested areas of research should include: 1)
learning about accreditation and how it would function within the
public health system; 2) evaluating the implementation of a national
agency accreditation system; 3) long-term follow-up on whether having
an accreditation system has lead to improvements; 4) How have local and
state PH systems used the performance standards to make system
improvements; 5) has the use of the performance standards lead to
measureable impacts on systems functions; 6) has the use of the
performance standards lead to measureable change in the community's
health status; 7) what is the optimal structure, organization,
workforce, etc that best provides public health services to the
community? This is just a starter list and could easily be rapidly
expanded. Serious consideration of having a robust systems research
component should be your top priority. |
| 04/18/2005 |
12:19 |
PU |
393 |
X |
X12
Economics and Public Health- In addition to the economic aspects
outlined here regarding cost and efficacy, it is very important that we
also examine the broader, macro-level economic patterns and how they
influence the infrastructure for creating healthy communities -
communities which foster, encourage and enable healthy living. X13
Social and Behavioral Sciences in Public Health. I agree that
understanding the social determinants of health is a critical part of
the CDC research agenda and a huge cross cutting issue. By 'looking
upstream' we will be much better able to design and implement health
prevention policies and programs that implove the health and well being
of entire populations.
An element lacking in the research agenda is the issue of geographic
disparities. More attention should be placed on understanding the
geographic disparities in health patterns, and the varying geographic
patterns that exist for different racial/ethnic groups. Identifying and
monitoring geographic disparities in health enables health
professionals to tailor intervention to the needs of specific
communities and provides insights into new or previosly unidentified
risk factors and risk conditions.
It is also important to underscore the need to address racial/ethnic
disparities in health. Longstanding historical conditions of
discrimination and racism underlie many of the health disparities
observed today. We must better understand and work to eliminate the
racial/ethnic disparities observed in the United States. |
| 04/18/2005 |
11:15 |
PU |
389 |
X |
Facilitate
formal resolutions to allow for the the access of educational records
for public health activities with appropriate safeguards. |
| 04/18/2005 |
08:36 |
PU |
382 |
X |
This
may be in there, but...seems esential to focus effort on combining data
collection efforts across chronic diseases to give a more comprehensive
picture of their interrelationships and to reduce the cost of these
activities, increase efficiency and accuracy of comparaison across
programs and diseases areas, to better understand common risk factors... |
| 04/18/2005 |
07:27 |
PU |
376 |
X |
A
reasonable and comprehensive strategy to disseminate research findings
to parents of the children who could benefit from the results of
research should be a prominent component of this agenda. Educating
families to use this information in advocating for health servcies for
their children should |
| 04/18/2005 |
06:24 |
PU |
374 |
X |
As
with many of the other topics, agenda sounds like a vacuum rather than
you want to do the same research that a large number of research
organizations have been doing for years. On survey response rate,
population could be used generically. If not, CDC surveys target some
variety of "populations" and some of those (e.g., MD's, nursing homes)
may have special issues. |
| 04/17/2005 |
17:54 |
PU |
371 |
X |
A
study of the health and wellbeing of prisoners in the US -- According
to a Human Rights Report over two million U.S. persons are in prison, a
higher percentage of its people than any other country. Even more
troubling is the extent to which these persons are African American.
While only 12% of the population is black, 44% of all prisoners in the
U.S. are Black. Hispanics are approximately 13% of the population but
18% of the prisoners. In the majority of states the ratio of the Black
percent of the incarcerated population to the Black percent of state
residents is more than 4. Nearly 5% of black men compared to .6% of
white men are incarcerated. We should study the effect on families,
children and the community when such a high proportion of the
population is in prison. We should study the conditions that these
prisoners live in. A recent report by Human Rights Watch, Ill-Equipped:
U. S. Prisons and Offenders with Mental Illness states that one in six
U.S prisoners is mentally ill, many from very serious illnesses such as
schizophrenia, bipolar disorder, and major depression. (If they are not
ill when they go in, they probably are before they leave).
Unfortunately, the woefully deficient health services in many, if not
most prisons leave prisoners untreated or inadequately treated. This is
especially true for the mentally ill. From January, 1995 until March,
2002, 83 people had committed suicide while prisoners in New York State
alone. A recent article in the New York Times (Private Health Care in
Jails Can Be a Death Sentence, February 27, 2005) describes the
deplorable state of health care, including patients dying without any
medical attention, medical staffs trimmed to the bone, underqualified
or out of reach, prescription drugs not ordered or withheld, unread
patient charts, etc. In New York, a physician from DC, overseeing care
in different jails overruled doctors in the jails, refused to allow
them to give drugs and treatments to prisoners when he never saw the
patients and was not even licensed to practice there. Medical care in
prisons is often woefully inadequate. In some prisons untrained
correctional officers with no medical background are responsible for
dispensing medications. This is a problem for many reasons, e.g.,
medications are allowed to run out, privacy concerns, untrained staff
may unknowingly distribute the wrong medication or the dosage, or
distribute it at the wrong time. In others, as described in the NY
Times article, they simply don't care. Other concerns are lock downs
for 23 hours a day for prisoners (In Illinois, for months or even
years. This is torture.), the lack of a adequate and healthy diet,
abuse by guards, lack of exercise, and lack of educational materials,
training and courses that would help them make the transition back into
the community. Patients who have medical problems need to be properly
diagnosed and treated. Patients with TB or AIDs or any number of other
infectious diseases will spread the disease to others not only in
prison but to family and community when they get out. Thus, we should
look at the following: number of deaths, whether patients have medical
care available at all times, whether doctors and nurses are qualified,
whether drugs and treatments are available and correctly dispensed to
the right patients,
whether the conditions the patients live in are fit for human
habitation, whether the food is nutritious, whether prisoners are
challenged and given the opportunity to take classes so that they will
be able to survive when they leave prison, etc. |
| 04/17/2005 |
14:00 |
PU |
370 |
X |
The
World Health Organization famously said several years ago that there
can be no health without mental health. Mental health, perhaps more
than any other area relates to many of the major research priorities;
affecting the obesity epidemic, violence, injury, cardiovascular
disease, and HIV/AIDS, among others. Mental health is a across-cutting
research area and should be included in the starter list. Second only
to heart disease, depression, is predicted to be the leading cause of
death by the year 2020. CDC would be well-positioned ahead of the curve
by adressing mental in the work across CIOs and Coordinating Centers. |
| 04/17/2005 |
12:20 |
PU |
369 |
X |
Each
of the items in this starter list seem to apply to worker health issues
as well as to general public health issues. If this is not the intent,
it should be and the language should make that clear. |
| 04/15/2005 |
16:18 |
PU |
366 |
X |
Changing patterns of adult antibiotic use after implementation of Medicare Part D
(my hypothesis is that adults will be using more antibiotics, especially more expensive broad spectrum ones) |
| 04/15/2005 |
15:30 |
PU |
365 |
X |
Just
to re-iterate the importance of workforce development (making it
broadly available to health staff and not limiting to upper
management), and also Systems approach to design, development,
implementation and evaluation of disease control. |
| 04/15/2005 |
14:15 |
PU |
362 |
X |
To
Theme X14, "Mental Health and Substance Abuse", under "Examples of
Research Activities" would suggest adding: "Evaluate the influence of
mental health/mental illness on engagement in health protection
activities and/or risk behaviors". Although it has not traditionally
been CDC's role to assess or treat mental health, it is difficult to
ignore the important interactive role it plays in the presence or
absence of health protective behaviors. |
| 04/15/2005 |
14:13 |
PU |
361 |
X |
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 |
09:06 |
PU |
348 |
X |
Funding
to support research which evaluates the effect of laws and regulations
upon the public's health is greatly needed. In addition, funding is
needed to support evaluation of the structural and functional
variability of the public health system state to state. Research is
needed which demonstrates the impact of public health services. |
| 04/14/2005 |
14:18 |
PU |
337 |
X |
It
is good that genomics is listed here as Dr. Muin Khoury has rightly
been advocating this for a LONG time! Some of the other areas are less
cross-cutting but I guess CDC needs to pay lip service for these. |
| 04/14/2005 |
13:26 |
PU |
332 |
X |
Important
for these ideas to not be developed and implemented in isolation from
relevant program area. Under burden of disease, develop methods to
capture benefits of mature programs - if we really want diphtheria back
as a major cause of death in the United States, we can get it back. |
| 04/14/2005 |
12:38 |
PU |
328 |
X |
One
area I would really like to see developed is the use of
paraprofessional health workers in rural areas. Alaska's Community
Health Aid Program has done wonders for rural Alaska, but there are
resources still untapped. I'd like to see more community-based reserach
that trains members of communities (especially rural communities) in
basic health education, needs assessment, prevention/health promotion,
community development, and program evaluation skills. |
| 04/14/2005 |
12:30 |
PU |
326 |
X |
GIS
systems have been sorely under utilized in PH. Spatial relationships
abound in all population sciences. Our connection to the earth, its
weather, its terrain are unquestionable, yet we as PH experts continue
to overlook this very important relationship. CDC needs to expand its
expertise in using spatial methods and statistics, interpretting the
results, and translating the information into PH practice. |
| 04/14/2005 |
12:13 |
PU |
322 |
X |
This is good and appropriately placed. |
| 04/14/2005 |
11:43 |
PU |
318 |
X |
There
is surprisingly little methodological research in here-- i.e., research
that pertains to the quality of information we obtain from surveys and
surveillance systems. This could include a wide variety of initiatives
on measurement error in surveys-- for example, experimentation and
other social science investigation related to how questionnaire design
decisions affect the quality of data; improving methods for evaluating
the validity of statistical survey data; research into the cognitive
aspects of survey methodology, and so on. Beyond work on questionnaires
and response errors, there are wide areas of survey methodology related
to mode of data collection, sampling, imputation, and interviewer
effects that are ripe for additional research, as they are all
fundamental issues related to data quality. |
| 04/14/2005 |
11:05 |
PU |
315 |
X |
Develop tools to help people prioritize the necessary lifestyle and healthstyle issues they need to change. |
| 04/13/2005 |
15:59 |
PU |
287 |
X |
We
are currently unable to obtain some of the tools we need to manage and
analyze data. This is apparently due to both budget constraints and to
inefficiency in decision-making with regard to software to meet
scientific research and evaluation needs. It is inconceivable to me
that scientists in an agency like CDC are in this predicament. |
| 04/13/2005 |
14:17 |
PU |
280 |
X |
The
starter list is thin on what I believe is the research area that could
bring the biggest payoff in improving the health of the public. I'm
speaking of research into how to improve the public health system
itself--the governmental system in particular, but the entire system
too. Items X8 and X11 seem to get us part way there, but much more
needs doing in this area. We need to know, for example, what type of
state-level system is best, what kind of state/local interaction pays
off, what kind of funding arrangements for state and local PH are
optimal, how much funding is the right amount. Do boards of health
work? Should health officials report to boards, rather than to
governors or county executives? What is the impact of the very fast
turnover of senior state and local health officials on the quality of
public health services. Etc., etc. There is much to be done. CDC has
long given this category of research short shrift. And no one else but
CDC can really do it adequately. |
| 04/13/2005 |
11:00 |
PU |
274 |
X |
It
would be very helpful to have research conducted at the Public Health
Office level to asertain what their information and education needs
really are, and what equipment they have available on site to receive
information and education communications from the CDC. Equipment such
as Satellite receiving equipment, web streaming receiving equipment,
telephone bridges and/or speaker phones, VCR, DVD and CD players, etc.
Also are they planning to upgrade to HD Television related receiving
and playback equipment, and if so, when do they expect to do so. |
| 04/13/2005 |
10:22 |
PU |
272 |
X |
Development of short scales for assessing alchohol, inhalant and/or drug abuse among use. |
| 04/13/2005 |
09:55 |
PU |
270 |
X |
I
see three issues which should be addressed: 1) Broader economic
analyses; 2) More sophisticated economic measurements; 3) Standards for
determining social value and/or value from stakeholders' perspectives
1) Economic evaluation (cost-effectiveness, cost-benefit) and
structured analyses such as business cases are extremely useful in
determining policies regarding individual interventions. HOWEVER, there
is a need to move beyond microeconomic analyses to broader economic
investigation of markets that provide vaccines, drugs, and health care.
For example, the recent Institute of Medicine report on vaccine finance
that recommends replacement of Vaccines for Children is based on
one-sided, and in some cases just plain faulty, economic analysis of
the vaccine markets. As with MDs, economists specialize in different
areas. There are a number of economists already working at CDC who have
the ability to examine market fundamentals and provide advice on
policies that will protect the provision of goods and services
necessary to promoting public health. There is already some work
underway examining the fundamentals of vaccine markets to make
recommendations about policies to protect vaccine supplies. This work
should be expanded and begin to incorporate other areas of public
health. 2) There is a tendency to latch on to economic measurements
without thinking them through in the context within which they are
used, or examining how they were developed. In particular, QALYs and
DALYs are often perceived as objective measures. Unfortunately, they
are not and both come with significant methodological and ethical
issues. CDC should sponsor a series of conferences to determine
standards for these measures and their use. 3) There are standards for
economic evaluations but they are not well advertised and, more often
than not, are not followed. In fact, most societal perspectives are
really government perspectives and rarely include the difficult to
quantify -- lost time in a career for caregiving as an example. In
addition, when making policy, it would be important to look at most
studies from a variety of perspectives -- individual, supplier,
provider, etc. CDC should hold a series of professional seminars about
existing standards and hold debates about the appropriateness of these
standards, developing new ones where necessary. |
| 04/13/2005 |
07:49 |
PU |
266 |
X |
Research
Agenda : National Vision Program (NVP) /CDC/ Division of Diabetes
Translation (DDT)
X 2 Data Science and Information Systems
Identify and develop the best methods to identify, obtain, link, and
analyze new and emerging sources of data, and integrate and manage
information systems in support of 1. Identify the most effective ways
to integrate different health information systems, such as EMR, through
the development of data standards, new technology, and innovative
software tools and data bases.
2. Continue to work with the OCHIT in the design of a comprehensive HIT
architecture that assures data quality and access to surveillance
information.
3. Explore the potential for real time surveillance systems.
X 3 Disease, Injury, Disability and Exposure Surveillance
Develop new health surveillance methods and improve health surveillance
systems for better detection, analysis, evaluation and control of
diseases, injuries, disabilities and harmful exposures to protect the
health of communities. 1. Evaluate different components of eye / health
surveillance systems o improve performance.
2. Improve coordination among all involved eye/ health providers and
institutions.
3. Improve rapid detection and reporting of emerging infectious
diseases and harmful exposures.
4. Explore links of eye/ health to areas of homeland security.
X 4 Burden of Disease Develop methods to measure and compare the
relative burdens of specific diseases, injuries, and other adverse
health conditions in order to implement the mix of public health
interventions which will reduce or prevent the greatest amount of total
health burden.
1. Develop new and improved methods to assess current and predict
future trends for eye/ health burdens.
2. Burden assessment will be comprehensive including; acute, chronic
illnesses, death, quality of life and well being, and economic and
social costs.
3. Estimate preventable burden of eye/ health disease for appropriate
allocation of resources. Cost to benefit ratio.
X 5 Eliminating Health Disparities
Develop and promote Develop and promote the use of effective methods,
including interventions, in disadvantaged populations to characterize
and reduce or eliminate modifiable health disparities based on gender,
age or life-stage, race, ethnicity, nationality, geographic location,
disability, income, wealth, education, and other social determinants of
health.
1. Investigate health disparities amongst people with eye/ health
disabilities, especially in minority populations.
2. Evaluate fundamental causes of ill-eye/ health and disparities in
disadvantaged populations.
3. Investigate access issues related to eye/ health.
X 7 Health Education , Communication and Marketing
Develop effective health education, communication and marketing
strategies and tools to 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. Evaluate new methods to improve eye/health literacy, especially
among disadvantaged or poorly educated populations.
2. Investigate methods of encouraging populations to advance from being
aware of eye/health issues to taking actions to promote their
eye/health and prevent or reduce illness, injury or disability related
to eye/ health.
X 9 Public Health Impact Evaluation
Improve evaluation methods and conduct evaluations on the public health
impact of interventions, programs, and policies. 1. Evaluate the
relationship between health insurance coverage, access to eye care and
compare the costs to the benefits of the use of non used coverage and
the impact of expanded coverage.
2. Evaluate how public eye/health programs can be structured to
efficiently deliver the best services, improve health and build
capacity.
X 10 Translation and Dissemination of Effective Interventions
Conduct research on effective methods to translate research findings
into interventions and programs, and to disseminate effective
interventions and programs. 1. Improve the dissemination, adoption and
effectiveness of interventions that have been shown to be efficacious
in prior research.
2. Develop systems of eye/ health care that enhance delivery and
surveillance efforts that promote HP 2010 objectives as outlined in
focus area 28.1, 28.2, 28.5 and 28.6.
X 12 Economics and Public Health Develop and apply economic theories
and methods to examine the supply and demand for public health, to
estimate the monetary and social costs of diseases and injuries, and to
improve the delivery of health care prevention, treatment and
rehabilitation services.
1. Develop models on how public health agencies and health care
providers can most efficiently optimize resources to provide the best
mix of eye/health interventions.
2. Develop models that describe optimum communication strategies
between health care providers and provide the economic justification
for the use of these models.
X 16 Public Health Law and Policy
Determine the impact and effectiveness of legally-mandated public
health interventions and programs in different community settings, and
improve the translation of research findings into appropriate and
effective legal strategies designed to protect public health.
1. Determine the impact and effectiveness of legally- mandated vision
testing conducted by the Department of Motor Vehicles (DMV), Military
Entrance Exams, Flight Physicals and others within various community
settings including the low income or working poor, urban, rural, brown
areas, green areas, insured community and uninsured community.
2. Determine if enhancements to this system would be an appropriate
legal tool to improve the translation of eye/ health research findings
into effective strategies designed to protect public health.
3. Determine if other appropriate legal strategies exist in the areas
of legislative (State, Local and Federal), administrative (rulemaking),
and legal challenges vs. impediments to protect the public eye/health.
4. Develop template for comparing the effectiveness and efficiency of
laws and mandatory regulations in addressing chronic public health
problems in achieving health impacts.
|
| 04/12/2005 |
14:51 |
PU |
264 |
X |
•
Cross-cutting Research: Under Health Education, consider dentistry’s
potential role in nutritional counseling as one way to bring additional
resources to bear on the obesity epidemic. |
| 04/11/2005 |
15:51 |
PU |
258 |
X |
These are excellent ideas. The challenge will be to manage these projects as they really ARE cross cutting. |
| 04/11/2005 |
09:59 |
OH |
251 |
X |
see general discussion comment below |
| 04/11/2005 |
09:26 |
PU |
242 |
X |
Under
the Health Systems Research topic, please include factors affecting
demand for health (access to care, insurance, income, stigma, KAB), as
well as factors affecting the supply of health care |
| 04/11/2005 |
07:49 |
PU |
238 |
X |
To
do cross cutting you need to set priorities. The found solutions meet
the combined needs of all but don't fully meet the needs of any. I
think that is a problem or a lot of programs.....What are the programs
willing to give up categorically in order to have a better overall
outcome.....a holistic solution rather than a categorial one....Can the
immunization program give up 3 to 5% of their current coverage rates in
return for a combined program that increases exercise, decreases
tobacco use in kids, and promotes an 8th grade Dr. visit for
adolescents around sexual health.... |
| 04/08/2005 |
08:45 |
PU |
232 |
X |
This category does not seem entirely clear in its parameters. |
| 04/08/2005 |
07:39 |
PU |
230 |
X |
X4 is a solid idea |
| 04/07/2005 |
19:03 |
PU |
227 |
X |
This looks like a very interesting research agenda. |
| 04/07/2005 |
16:14 |
PU |
226 |
X |
Explore
and develop analytic protocols for evaluationg community as the unit of
analysis in constrast to the indiviual. Explore the determinants of
community, including race/ethnicity, such as history, culture, context
and geography and their role in addressing barriers and determining
solutions related to behavior change, policy development, and
environmental change. The development of new methodology, based on
quantitative and qualitative methods, will be necessary. |
| 04/07/2005 |
15:59 |
PU |
224 |
X |
X5
- Assess and develop literature that expands on the utility of using
acculturation scales for population identification as well as tailoring
of public health messages and strategies to new Americans.
X10 - Assess and develop analytical methods to respond to
culturally-embedded public health concepts of at-risk populations. |
| 04/07/2005 |
14:32 |
PU |
219 |
X |
To
assist both "Community preparadness and response" and "Enviroinmental
and Ocupational Health research", CDC could support developmental and
evaluative research on the application of advanced imaging methods for
early detection and improved evaluation of active disease. A century
ago, X-ray radiology revolutionized medical diagnostics. A similar
event is occuring now with new imaging technologies, e.g., magnetic
resonance imaging (MRI) and positron emission tomography (PRT-scan).
While these are now becoming routine elements of clinical practice for
cancer detection and staging, their further development and testing
could be speeded for other than cancer environmental/occupational
problems, e.g., early detection of lung fibrosis from occupational
exposures (for instsnce, to better determine the nature of pulmonary
problems currently manifest in WTC 9-11 responders as seen in the
recent Mt. Sinai study /MMWR report) (J Nuc Med 2002;43:413); or to
provide objective measures of occupational injury. In some cases these
might shorten time to diagnosis from decades to prompt identification
by non-invasive detection of active disease process, e.g., for lung
fibrosis). That in turn might profoundly affect the standard paradigm
for medical surveillance of some special populations at risk. CDC could
do this by (1) applications research on advanced imaging methods for
specific environmental/occupational disease or injury; and by (2)
support for limited clinical evaluation/application at a small number
of selected clinics where bellweather cases could be addressed, e.g.,
selected WTC responders in NYC, surface coal miners in western
Pennsylvania. |
| 04/07/2005 |
13:47 |
PU |
218 |
X |
workforce research, community-based participatory research, pedagogical research |
| 04/07/2005 |
13:47 |
PU |
217 |
X |
public health systems research |
| 04/07/2005 |
10:40 |
PU |
213 |
X |
One
of the basic tools that many programs at CDC employ is the controlled
clinical trial (CCT). Two aspects of CCTs are particularly relevant to
CDC. First, some CCTs are needed because the outcome of the trial may
have significant public health impact or implications (e.g., the
ongoing Tenofovir HIV prevention trials). Second, some types of CCTs
can best (or only) be implemented in or through the public health
sector (e.g., trials of new therapies in tuberculosis treatment; e.g.,
trials of new regimens for treatment of gonorrhea). In some instances,
it is difficult to conceive that CCTs in an area important to CDC would
be conducted if the activity is not supported by CDC. Inclusion of the
methodologic aspects as well as specific applications of the CCT in the
public health setting thus merit a significant place on the CDC
research agenda. |
| 04/07/2005 |
10:20 |
PU |
210 |
X |
Researcher
should make a focused effort to determine "what works' in
disenfranchised communities (promotoras or community health workers for
example) and submit those mechanisms to rigorous research to add
credibility to these effective community strategies. |
| 04/07/2005 |
10:09 |
PU |
209 |
X |
Analyze
the cost/benefit impact of increasing percentages of contractors at the
federal public health level.
Analyze public health law and ethics in relation to the technology
transfer process, public/private collaborations, and CDC/NIH interfaces. |
| 04/07/2005 |
09:39 |
PU |
203 |
X |
Conspicuously absent from the health disparities research priority is sexual orientation. |
| 04/07/2005 |
09:24 |
PU |
202 |
X |
validation
of items in existing surveillance systems is needed. Addressing
surveillance gaps for children 6-12 for chronic disease prevention is
urgently needed. |
| 04/07/2005 |
09:19 |
PU |
201 |
X |
automate sequence retrieval, alignment, and phylogenetic tree creation. |
| 04/07/2005 |
08:53 |
PU |
199 |
X |
Not
sure where these fit, but having prevention research centers across the
country funded by CDC (currently housed in the chronic center) for
reasearchers to translate public health applicable interventions and
also implement demonstration projects ssems a good idea that each of
the centers/offices could take advantage of. |
| 04/07/2005 |
06:45 |
PU |
190 |
X |
Analytical
methods and equipment with which to develop them are important for
continued improvement in all areas from environmental to infectious
diseases and terrorism.
Ethics...I'm not convinced of the ethics of many ethicists. Seems like
a waste unless there is a legitimate moral basis for such ethics. |
| 04/06/2005 |
17:43 |
PU |
186 |
X |
I'm concerned to see "Ethics in Public Health" at the bottom of this unalphabetized list. |
| 04/06/2005 |
17:17 |
PU |
184 |
X |
One
of CDC's research priorities should be directed towards better
understanding the secular trend in the United States and many other
countries towards fewer autopsies; studies to better understand the
consequences of fewer autopsies with regard to physician education,
quality of medical care, public health surveillance, identification of
emerging and established infectious diseases, and accurate diagnoses of
chronic diseases, including neoplasms and rare neurological diseases. |
| 04/04/2005 |
11:05 |
PU |
147 |
X |
I also suggest some research into policy development and implementation processes. |
| 04/04/2005 |
10:53 |
PU |
146 |
X |
I
believe that we need to increase our efforts in motor vehicle automatic
crash notification systems. Specifically formulating mathematical
models that will improve our ability to predict those with significant
injuries and automatically notify prehospital personnel of the crash
event and the likelihood of severe injury based upon the crash
kinematics. |
| 04/03/2005 |
21:43 |
PU |
144 |
X |
X4.
AOD addiction is a diesea that needs more study as to its burdens on
society and individuals and all the public systems the government pays
for as well as the costs to private family systems and child
development
X5. alcohol abuse is a perfect example of a disease that causes
disparities in the response to its behavorial manifestations between
sexes, ages, and cultures
X7-8. be sure to inculde AOD addiction in this study of strategies to
change behavior. this would be a good place to evaluate community anti
drug coaltions and their effectiveness in health promotion. also study
the effect of advertising on unhealthy life style choices and pick up
where CAMY left off in tracking the impact of advertising on adloescent
decisions to use alcohol.
X9-14. these are all very important to better outcomes for the health
of thegeneral population as well as those at high risk.
X15. more work needs to be done in this area in relation to addictions.
X16. many of the most cost effective strategies may come frm this area
of investigation, especiall in the areas of alcohol, tobacco, andother
addicitions like gambling, misuse of perscription drugs, regulation of
meth ingredients, legal drinking age, etc.
|
| 04/01/2005 |
08:20 |
DC |
142 |
X |
CDC
should develop one tool for surveillance, including syndromic, to be
used nationally. Info can be reported once and access can be limited to
those who need it. |
| 03/30/2005 |
10:37 |
DC |
131 |
X |
Dissemniate info in a format (ie: workshops/seminars) for local hospitals to use to improve communication and report sharing |
| 03/28/2005 |
17:33 |
OH |
105 |
X |
As
I understand it this section will focus on themes that combine ideas
from any of the six target areas identified above as well as other
innovative ideas. If that is the case I will like to see more emphasis
of CDC on public health workforce development and training in
developing countries; research into globalization, poverty reduction
and public health; and investments in information technology and
impacts on public health. |
| 03/28/2005 |
13:29 |
DC |
102 |
X |
Centralized
data bases are needed by state or region to support f/u of major
communicable diseases, vaccine preventable diseases, etc. |
| 03/28/2005 |
12:25 |
WA |
85 |
X |
X6-Community-Based
Participatory Research, X5-Eliminating Health Disparities, and
X9-Public Health Impact Evaluation should all be linked to E4 in the
list from the Environmental and Occupational Health and Injury
Prevention Workgroup. These 3 cross-cutting topics are desperately
needed in Environmental Health and must be applied there. I work as an
Outreach Educational Specialist for toxic sites with the Washington
State Dept. of Health, a 1043 cooperative agreement partner with ATSDR
(Superfund), and a vast majority of the communities impacted from toxic
sites are either low-income, people of color, or new immigrants who
don't speak English well. Community-Based Participatory research is
badly needed in this area, particularly because of the hugely
disconnected communication gap between technical health professionals
and the communities they are supposed to serve. Effective,
community-piloted evaluations are also desperately needed and we
currently do not have the funding or the guidance to do them, although
we are mandated to do them through OMB. Please help! |
| 03/28/2005 |
09:17 |
DC |
65 |
X |
Health
outcome and cost-benefit studies on the use of personal protective
equipment: types of respiratory protection, frequency and utility of
fit-testing. |
| 03/28/2005 |
08:10 |
DC |
59 |
X |
The public health workforce is certainly dwindling because of lack of support at the state and local level. |
| 03/22/2005 |
12:08 |
WA |
37 |
X |
A
cross-cutting research area of unique importance is that of the
American Indian public health research. American Indians, Native
Americans and Alaska Natives are like no other racial or ethnic group
in the United States in terms of public health needs or research needs.
It is critical that cuturally sensitive research and research training
be launched to deal with the special public health issues surrounding
American Indian people, their communities, their public health
programs, clinics and hospitals. Disparities in public health research
to address their particular issues need to be addressed. -- Carol
Korenbrot, Research Advisor, California Rural Indian Health Board |
| 03/15/2005 |
15:09 |
WA |
29 |
X |
The
CDC Research agenda should include:
- an emphasis on community participatory research
- Academic or other institutional based research conducted at a
community level must involve the jurisdictional local public health
authority
- an emphasis on practice based research from the field - The practice
based field research needs to address questions of organizational and
structural effectiveness in the delivery of public health services.
|
| 03/09/2005 |
11:47 |
WA |
14 |
X |
Can
you tell me what is expected in terms of the format or public comment
at these meetings? How long will each speaker have? Will powerpoint and
multimedia presentations be allowed? Does one have to stay for the
breakout sessions? Do you allow testimonials?
Thank you, Monica Randall
|
| 02/25/2005 |
08:43 |
GA |
7 |
X |
Health disparities research. |
| 02/22/2005 |
09:17 |
OH |
2 |
X |
Would
be very useful if CDC were to develop more indicators of the quality of
care and the severity of patient safety problems, as part of its
ongoing efforts to assess public health. |
Back
to Top
|
| Date |
Time |
Type |
ID |
Group |
Comment
|
| 04/20/2005 |
09:53 |
PU |
473 |
D |
Internet trials to be soon held against those guilty of crimes against humanity by inoculation with disease on
www.againstthegrain.info
INTERNET RADIO BROADCASTS 11P-1AM MON-FRI EST
|
| 04/19/2005 |
21:38 |
PU |
468 |
D |
Given
the importance of this, perhaps we should have all-hands meetings for
each area and some discussion of how these were devised and what seems
to be the ongoing issues. You might get better feedback from group
discussions. |
| 04/19/2005 |
17:26 |
PU |
463 |
D |
Try
to distinguish this effort from the Futures Initiative-- I realize they
are related, but since alot of people feel left out of the Futures
implementation, to the extent they associate research agenda
development with it, they may not engage in agenda setting activities.
Updates once or twice a month, or after major steps completed, by
e-mail and on the website, would be welcome. Providing a timeline of
the agenda development process, and charting progress on it, would also
be helpful. Thanks for listening. |
| 04/19/2005 |
16:13 |
PU |
457 |
D |
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 |
15:52 |
PU |
454 |
D |
One
major area that gets little new research attention is the possible
connection between birth control pills and breast cancer as well as
abortion and breast cancer. Although much has been published, much of
the epidemiological work appears to be very poor resulting in
contradictory findings. |
| 04/19/2005 |
15:31 |
PU |
452 |
D |
It
doesn't seem like the ADSs were very involved in this effort. I did not
see the Center ADS meeting with the Division ADSs and asking them to
meet with their respective divisions, get feedback and return to the
Center ADS meeting with findings. We have this structure all set up but
it is underutilized. An e-mail saying to submit comments does not have
the same effect as having the ADS meet with the scientists to discuss
the issue.....especially something as important as our research agenda.
Because of the short turn-around time and the "futures initiative
fatigue factor", I sense an attitude of "Who cares, they will do what
they want to do" with they being the people on the top of the
management structure.
What is the definition of research?
The whole set is much too long. We should be able to come up with 10 or
fewer priority research areas for our research agenda. As is, this will
not be absorbed by the research community both internal and external to
CDC. All the Centers developed their own research agendas back in 2000.
These could be revised to fit into a simple overall CDC research agenda
in which the center or coordinating center specific areas would be
available when needed but not included in the overall CDC agenda. Thank
you for giving us the chance to give feedback! |
| 04/19/2005 |
14:21 |
PU |
447 |
D |
In
it's present form, the CDC research agenda lacks structure. It could
benefit from some rationale on how it relates to the accomplishment of
the CDC Mission "to promote health and quality of life by preventing
and controlling disease, injury , and disability." |
| 04/19/2005 |
13:42 |
PU |
442 |
D |
It
is certainly frustrating that the public comment period on our new
agency-wide research agenda was opened, to much fanfare, more than 6
weeks ago, but we received a request for comments within the agency 24
hours before the comment period was to close. It doesn't inspire much
confidence in the importance of our opinions to either the process or
content of this agenda.
Overall, it's a nice laundry list, mostly of pet projects, but it is
not clear why we need such an agenda. Who is setting the priorities? It
is not clear what impact "measuring the frequency of important gene
types" will have on public health, or how we are to measure the "impact
of common language on emergency response teams" when we don't even have
the trained personnel needed to serve on those teams. |
| 04/19/2005 |
13:27 |
PU |
440 |
D |
Where
does developing community level interventions to improve resilience
come in? People face tremendous stress nowadays and are responding to
that stress in maladaptive ways. We need to be leaders and innovators
in developing a public health approach to managing stress. |
| 04/19/2005 |
13:25 |
PU |
439 |
D |
Where
does developing community level interventions to improve resilience
come in? People face tremendous stress nowadays and are responding to
that stress in maladaptive ways. We need to be leaders and innovators
in developing a public health approach to managing stress. |
| 04/19/2005 |
12:03 |
PU |
434 |
D |
Where will the issues of oral health be addressed? |
| 04/19/2005 |
11:19 |
PU |
431 |
D |
I think it is sad that CDC does not have a research priority on "Eliminating Disparities" or on "Minority Health". |
| 04/19/2005 |
11:08 |
PU |
429 |
D |
Regardless
of what management says about developing a research agenda, many
laboratory researchers believe that our days are numbered here at CDC.
Laboratorians are being told to stop work on innovative basic research
projects. We are being told that our role is to only support epi
studies. Research will be done by the NIH. In light of the dismal state
of HIV vaccines, it is obvious that we need to encourage thinking
outside the box to solve this problem as well as the problem of
emerging infectious diseases.When you stop allowing the labs to do
cutting edge research, you will loose the abiltity to respond to new
threats. We must keep our labs up to date with the newest technologies
and encourage basic research ideas. I think it is great to develop
specific priorites and goals for research but we must remain open to
new ideas as they come along. This developing agenda must continue to
evolve over time. It is hard to believe that management is serious
about supporting "research agendas" in light of the day to day
decisions that are being made. |
| 04/19/2005 |
10:59 |
PU |
428 |
D |
no focus in maternal and child health either as a topic area or within specific content areas - this seems short sighted |
| 04/19/2005 |
10:36 |
PU |
427 |
D |
From
the perspective of NCHS, this is not at all satisfactory. We operate a
wide variety of data collection systems, and vital statistics and our
survey programs are the priority. Enhancing the integrity and stability
of these key programs is critical to addressing any research
priorities. If vital statistics and the surveys are not nurtured and
fully supported, then the research flowing from them will be tainted
and flawed. A key strength of vital statistics for example is the
extensive detail for racial and ethnic subpopulations as well as small
geographic units. The research agenda calls for addressing disparities,
but without serious and substantial investments in the vital statistics
program, this research cannot happen. Similarly, the cross cutting
agenda in theme ID# X13, Social and Behavioral Sciences in Public
Health refers to devising new qualitative and quantitative methods for
surveillance of behavioral risks associated with adverse health
outcomes. Why not instead put resources into the exisiting surveys, for
example the NSFG, NHANES, NHIS, to enhance the utility of these tried
and true and very highly regarded surveys to address these research
issues, instead of advocating new data collection systems?The real
danger is that we will see whatever [limited] resources there are go
into these new ideas and this will come at a big cost for the core
programs at NCHS. We're already seeing first hand that the alleged new
money for NCHS is not translating into needed support for enhancing the
existing systems.
|
| 04/19/2005 |
10:33 |
PU |
426 |
D |
I have spent over half an hour now looking thru this "starter list of research priorities,"
and the fact sheets that go with them. I am puzzled.
First, I'm not sure what their definition of "research" is.
The most important example of this is that I don't see one mention of Vital Statistics as a mission or priority for CDC.
If we don't have vital statistics, we have nothing.
Vital statistics is more important than anything I saw listed here.
Second, I also don't see one mention of population-based surveys like the NHIS, NSFG, and NHANES.
This is very strange.
Third, the list appears to be just a list of what CDC is already doing, in order to justify
what it's doing. In some cases, it lists things that someone would LIKE to be doing if they had more money.
Is that what our "agenda" is--a wish list from those who spoke up?
Fourth, it isn't clear what the process is going to be to decide what CDC's priorities are.
From the contents of this wish list, it seems pretty clear that people in Atlanta are going to get priority over Hyattsville.
If they use this list to make budget decisions, that would be downright scary.
Someone prominent needs to tell them that vital statistics and basic population surveys
are the foundation of their priority setting. They need to be supported.
The targeted research that's emphasized in these lists is a waste of time without the basic data
provided by vital statistics and population-based surveys--those data
tell you what you should be doing targeted research ON.
|
| 04/19/2005 |
10:29 |
PU |
424 |
D |
I
think that CDC should have initially involved our partners in public
health---those in CSTE. Ignoring these long-standing, intelligent
partners in the outreach stage of this current reorganization was an
enormous mistake, in my opinion. It has weakened our relationship with
them and was short-sighted. I would like to see that corrected. |
| 04/19/2005 |
10:23 |
PU |
423 |
D |
Part
of the intent of the CDC Health Protection Research Guide, 2006-2015 is
to prioritize research; however, I did not see anything about how the
priorities in the above seven areas were established nor how the
research themes will be prioritized relative to each other. Will CDC
pursue all themes equally? |
| 04/18/2005 |
16:26 |
PU |
414 |
D |
I
think we have critical knowledge gaps when it comes to program
evaluation-and creating a bigger prescense in the field. I think we
need to colloborate more with national experts (ie: Michael Quinn
Patton) and do alot more program evaluation here at CDC. There's alot
more to it than simply looking at surveillance type data and indicators. |
| 04/18/2005 |
16:18 |
PU |
413 |
D |
I
was curious on how genetics would fit into the research agenda. It is
cross cutting but specific enough to be a separate discipline. |
| 04/18/2005 |
15:18 |
PU |
409 |
D |
The
categories and starter lists, in general, seem very siloed and
program-oriented. I think much would be gained by CDC leading the
charge for a public health systems research category (listed first to
emphasize its role in building the foundation upon which programmatic
activities are undertaken). We know very little about public health
infrastructure and how we can improve the public health agencies and
workforce that are at the front line of public health. This is an
important area that could have great impact for all areas of CDC, as
well as for our national stakeholders. |
| 04/18/2005 |
13:14 |
PU |
397 |
D |
The
process that CDC used to establish the seven focus areas, and their
attendent starter lists, appears to have failed by not recognizing the
extreme importance of having good, basic research done on what kind of
public health system we have and how we can make sure it's functional
and accountable. Forget all those precious research dollars spent on
infectious disease, chronic disease, injury, etc if none of those
interventions or programs operate in an effective manner within
communities. This obvious mistake needs to be addressed, otherwise we
(CDC) risk wasting resources as well as alienating the supporting
public policy makers in cities, counties and states across the Nation. |
| 04/18/2005 |
11:15 |
PU |
389 |
D |
A
very nice start at developing the research agenda. Please make sure
issues of cumulative exposures are addressed and their impact on
disability. Also, an effort to develop methods to evaluated complicated
genetic and environmental interactions resulting in disease and
disability are needed. |
| 04/18/2005 |
09:23 |
PU |
384 |
D |
I
am leary of the need for an "agenda". Current research at CDC is
excellent. My greatest concern is CDC staff taking on too much (the
equivalent of Congress mandating but not funding). |
| 04/18/2005 |
08:36 |
PU |
382 |
D |
More
research and program development focus on addressing mental health
issues related to chronic disease (e.g., physiological impact of stress
and learned helplessness). This might include tracer studies that
follow patients over time and track stressors related to their
ineractions with the healthcare system----what innovative practices
seem most related to the reduction of these factors that reduce quality
of life by increasing debilitating complications and costs associated
with chronic disease. |
| 04/18/2005 |
08:09 |
PU |
379 |
D |
I
would like to see some connection to the private sector, where, in PA,
85% of immunizations are given. I would like to see more research on
what distinguishes high-performing practices from the average ones. I
would like to see training and resources to help the average start to
act more like the high performers. See Wishner A et al. Best Practices:
applying management analysis of excellence to immunization. J Med
Practice Management, March/April 2005, Vol. 20, No. 5, pp. 275-278.
This was a pilot project with a small sample -we could really use more
research in this area! |
| 04/18/2005 |
07:29 |
PU |
377 |
D |
After
a very quick read, I did not get the impression much is included on
vectorborne diseases in the U.S. or elsehere. Is that true? |
| 04/18/2005 |
06:24 |
PU |
374 |
D |
Too
little attention given to data quality issues and infrastructure needs
that come before one can do all this ambitious research. |
| 04/15/2005 |
14:13 |
PU |
361 |
D |
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 |
13:36 |
PU |
360 |
D |
I
suggest that CDC fund Evidence-based best practice community-wide
social ecological primary prevention interventions to address physical
inactivity, poor diet and other lifestyle patterns, instead of
fragmenting communities into less meaningful pieces. We must address
lifestyle problems within the context of where people live. |
| 04/15/2005 |
13:16 |
PU |
357 |
D |
As
before (and seems always) these strategies are exclusively “REactive”
and seem to address only the known/notifiable/occurring diseases in
areas where human population is already exposed and “suffering” . This
is good, necessary, extremely important, but as before leaves us
totally unprepared for any upcoming events and changes. What we need is
a PROactive strategy that would tell us what to expect and where before
humans are actually start falling sick. New lands are being developed;
urban sprawl puts people ever closer to the nature (I love leaving in
suburbs); large areas are being deforested or reforested; vector and
reservoir species compositions are changing ... I could go on and on.
If we new 20 years ago what we know today about natural cycle and foci
of Lyme disease, would it have such an impact on the nation as it have
had? Or would we be able to prepare for the effects of reforestation
and = prevent the “pandemic” at least partially? Well, currently
Amblyomma americanum is on the move and spreading allover and very
quickly, exceeding in abundance the existing ticks in many areas. Do we
know what these ticks carry, what they can transmit, how they affect
the existing vertebrate, vector and pathogen communities? Are we
prepared for a “pandemic” of STARI (or like) allover the Country?
Exotic ticks (and files I am sure) are being imported into the Country,
and some of those are getting a firm footing here. Are
we/public/doctors prepared to prevent, recognize, and treat hartwater,
African tick fever, CCHF, or is it going to be another thunder from a
seemingly blue sky?
And these are just the most apparent threats. In short, we need a
strategy and a system (something like a network of perpetual monitoring
stations) to monitor the natural foci regardless of the presence or
absence of an already suffering human population. |
| 04/15/2005 |
12:22 |
PU |
354 |
D |
A
question, for up thru year 2010 how does the CDC research agenda
support and advance national health goals specifed in HHS Heatlhy
People 2010 and recent reports of the USPHS Office of the Surgeon
General?
Thank you. |
| 04/15/2005 |
09:25 |
PU |
349 |
D |
This
is a very comprehensive and fairly exhaustive list of potential
research topics. The shear size of the list covering so many topics
raises several questions:
1) How will the agenda be used? That should be prominently featured at
the start of future documents.
2) How will priorities be set? Will the priorities be based on the
categories currently listed in the agenda or will some other process be
used to deal with diseases that have the greatest health burden. For
example, while HIV is mentioned in the document in multiple areas, many
of the goals could encompass research on HIV. It would be important to
spell out the process the agency will use to set priorities among the
many potential research projects. It would be helpful if that priority
setting process was transparent and allowed for public input.
3) How will the agenda influence CDC's budget allocations for research?
4) How will the agenda be administered within CDC? |
| 04/15/2005 |
09:06 |
PU |
348 |
D |
Thank you for this opportunity. |
| 04/14/2005 |
19:00 |
PU |
342 |
D |
Would surveillance go here? |
| 04/14/2005 |
14:18 |
PU |
337 |
D |
Thank you for giving us an opportunity to comment and provide input! |
| 04/14/2005 |
13:57 |
PU |
335 |
D |
Resist methodologically inane projects and projects that are driven by politics, not science. |
| 04/14/2005 |
13:49 |
PU |
333 |
D |
Overall
I was sorry to see so little specific attention to women (aside from
their role as mothers) and recommend including women's health with a
focus on gender and health care, contraception (access and new
technologies), domestic violence, abortion and infertility. |
| 04/14/2005 |
13:26 |
PU |
332 |
D |
While
this is an interesting compendium, I find it difficult to envision how
it will actually be used - without prioritization it is simply a wish
list. Who will prioritize it, and how will they do it? Those are key
questions that are unclear to me from the materials provided. |
| 04/14/2005 |
12:30 |
PU |
326 |
D |
CDC
has a unique position as a national and world PH authority. We own or
have access to more PH information than any other PH entity. We need to
take advantage of modern technology to organize and disseminate this
wealth. Most PH events are local and the value of easily obtained
pre-event baseline data via a variety of access methods can be
invaluable both in an emergency and for routine management and
administration issues. |
| 04/14/2005 |
11:33 |
PU |
316 |
D |
A
lot of what CDC does is research, but not everything is research. For
example, a lot of what we do is program oriented that has little or no
research component. Some of the items in the starter list seem more
program than research oriented. For example, its not clear what the
research componant is of developing systems. There may well be a
research componant, but its not clear from the starter list. I worry
that the methods used to gather information for the starter list got a
little off focus and began to inventory CDC activities, independent of
whether or not they included a research component. The text seems
somewhat distant from what I imagine to be actual research questions
that would ultimately drive the agenda. Alot of pruning and drilling
down will be needed. Currently the list appears to be organized by
content area. I would suggest possibly organizing the starter list or
actual agenda by types of research, rather than by content area.
Researchers skill sets may be more readilly characterized my the kind
of research they do, rather than a particular content area, though
certainly they can often be distinguished by content area as well.
Examples of types of research might include:
Evaluation research,
Basic science or laboratory research,
Behavioral research,
Methods development research,
Population public heatlh research,
Clinical research,
Informatics or IT systems research,
Economic and cost effectiveness research.
Those are just some possible examples, but you can see that within a
content area such as Infectious diseases, there are several different
kinds of researchers and research activities. These researchers might
identify more with the type of research they do rather than the
particular subject area they apply it toward. Organizing in this way
may help facilitate construction of the actual research questions that
drive the agenda.
Within these broader categories, there may be subcategories that help
organize the agenda. For example within population research, one
subcategory could be risk factor research, etc. Perhaps what would be
helpful is to work on a hierarchical classification of research types
to assist with organizing the agenda.
. |
| 04/14/2005 |
10:39 |
PU |
310 |
D |
This
list of research areas looks good to me. I think the research agenda
should be reviewed and updated only every 2-3 years unless there is a
major change in our population's health or in our health care system
that warrants immediate study and addition to the CDC Health Protection
Research Guide, 2006-2015. |
| 04/14/2005 |
10:35 |
PU |
309 |
D |
It looks like the right people are not involved in the process. |
| 04/14/2005 |
10:31 |
PU |
308 |
D |
Though
under "cross-cutting" perhaps Health Disparities in the US should be a
separate and expansive research agenda. We remain a country that
refuses to address these issues in the medical and health systems, and
it is our responsibility to address them? Segregation in hospital care
and access?
Physician and emergency technical care and outcomes?
Minority health issues? (Dekalb Counties infant mortality rates?)
Obesity and education?
This is an issue which hits us here in our own backyard hardest of all?
|
| 04/13/2005 |
16:06 |
PU |
288 |
D |
It
is unclear how cross-cutting activities will be implemented across many
CIOs and coordinating centers and how evaluation and impact factors
will be incorporated into specific projects. Although we have asked for
copies of our CIO strategic plan (much less coordinating center),
management has not shown us how our project impact measures fit into
our CIO or division strategic plans.
It would be useful to have it written in the final plan to explain all
this to the folks and stakeholders at the bottom of the food-chain,
those of us who have to actually do the work and come up with the
research proposals. |
| 04/13/2005 |
13:49 |
PU |
278 |
D |
Your priorities are on target but very sweeping. Will your budget sustain meaningful research in all of these areas?
If not, it would probably be better to limit and be more specific so that your outcomes are discernible.
|
| 04/13/2005 |
10:22 |
PU |
272 |
D |
Appreciate this process. |
| 04/13/2005 |
09:59 |
PU |
271 |
D |
It
is critical for the CDC to place more emphasis upon training future
laboratory research leaders. We need better communication between
laboratory scientists and epidemiologists through more crosscutting
laboratory training. We should pattern a Laboratory Research
Investigation Service after the model of the EIS. This will be critical
to meet present and future challenges to public health. |
| 04/13/2005 |
09:10 |
PU |
268 |
D |
I believe health disparities should be included as a distinct category if we are committed to bridge that gap. |
| 04/13/2005 |
08:22 |
PU |
267 |
D |
All
of the women's health goals seem focused on conception, pregnancy, and
childbirth. More maternal health than women's health. I would encourage
the CDC to think of women's health more broadly, including an emphasis
on gender-based differences in presentation and treatment of chronic
diseases. Other important areas in women's health: aging, other
reproductive health areas (birth control, abortion, STDs), and violence
against women. |
| 04/13/2005 |
07:49 |
PU |
266 |
D |
The
National Vision Program (NVP) CDC Division of Diabetes Translation
(DDT) NCCDPHP was pleased to participate in this exercise. This process
should be repeated every 3-5 years and should be considered an
essential component for all CDC programs.The information should be
complied in a manner that would contribute to the further development
of collaborative approaches within CDC/A |
| 04/12/2005 |
17:58 |
PU |
265 |
D |
Of
the universe of possible research activities, our priorities should be
research that informs CDC's programmatic activities. Some of the
research themes here are so broad that there is little to comment on,
and many of the examples of research activity are not specific enough
to serve as examples (see my specific comments on #4 above). Moreover,
a number of these examples are badly in need of editing for clarity and
consistency with basic research principles. CDC should seek the advice
of people like Dr. Judith Auerbach, formerly of NIH, who has actually
succeeded in getting a large Federal agency to create a detailed plan
for its prevention research, to adopt a process for updating the plan
annually, and, over a 5-year period, to fund what was stated in the
plan. She is now at AMFAR in Washington, D.C. I know we aren't NIH, but
we don't have start from scratch. |
| 04/12/2005 |
14:51 |
PU |
264 |
D |
CDC
Health Protection Research Guide, 2006-2015
Written Statement of the American Association for Dental Research
(AADR)
Introduction:
The AADR, a fully incorporated non-profit organization and the largest
Division of the International Association for Dental Research,
represents nearly 5,000 dental researchers in the US. The AADR commends
the Centers for Disease Control & Prevention for its decision to
develop a CDC-wide, comprehensive research agenda, and we appreciate
the opportunity to participate in the process of developing this
agenda. Research in the oral health arena spans many areas of science
from the more traditional dental materials, cariology, and periodontal
research to behavioral sciences & health services research,
neuroscience, pharmacology and salivary research. In fact, there are 21
distinct scientific research groups within IADR/AADR covering the above
areas and many others.
Through a Memorandum of Understanding , the AADR is a full partner with
the US Department of Health & Human Services in promoting the oral
health objectives of Healthy People 2010 and the National Call to
Action to Promote Oral Health of the US Surgeon General . Through
IADR/AADR professional meetings and publications, we have sought to
bring wider attention to the disparities in oral health that exist and
the need to build the science base and accelerate science transfer. In
the latter vein, the AADR supports broad dissemination and
consideration of the research agenda developed by the American Dental
Association to address issues of importance to the practicing dentist
[ADA Council on Scientific Affairs, November 2004]. In recent years,
the AADR has promoted, through its Congressional testimony and fact
sheets, the need to recognize the potential of saliva-based
diagnostics; the value of practice-based research networks involving
dental clinicians; the growing evidence of a connection between
periodontal diseases and systemic conditions, such as heart disease,
diabetes and low birth weight babies; and the need to address the most
common affliction of childhood, i.e., dental caries. The AADR believes
fervently that oral health research can make significant contributions
to human health and that, wherever possible, should be a key
collaborative partner with the overall medical research enterprise. In
addition to supporting biomedical and clinical research, the AADR also
believes that support for science transfer, epidemiology, and
prevention research are critical. Thus, we have supported funding for
the continued inclusion of oral health in the ongoing NHANES and for
the CDC’s Division of Oral Health to “put science into action by
developing and testing interventions to prevent oral diseases …
including work(ing) with states to extend sound public health policies
and programs ...” The dental research community stands ready to
contribute to the CDC Health Protection Research Guide, 2006-2015 and
to help pursue the types of research that have been, and will be,
identified by this agenda. Additional comments are arranged and
submitted in the categories outlined on the CDC web site.
|
| 04/11/2005 |
15:51 |
PU |
258 |
D |
Overall
I think it is very important to have a research agenda. This is an
ambitious task. I worry a little about having Congress edit the agenda
with its red funds-cutting pen. Still, we need to MANAGE the research
here as well as conduct it. Looking to the future, I think it is
critical for the "younger generation" to be part of the picture in
planning this so that there is a group of people at CDC ready to keep
this going--a group who understands the Big Picture the research agenda
represents. Good luck. |
| 04/11/2005 |
11:11 |
PU |
254 |
D |
Although
these topics for the research agenda seem fine at first glance, they
are so broad, that there is little if any current research which is not
included in these categories. Therefore, I would say it's difficult to
provide useful comment on the topics. Although this broad scope may be
intentional at this point, it would seem more helpful to have specific
topics which are the main focus for this fiscal year. I'm not sure what
good it will do us to have broad topics for a research agenda that
encompass what CDC is already doing. |
| 04/11/2005 |
09:59 |
OH |
251 |
D |
Promotion,
prevention, and reduction of mental health morbidity and related
economic and human capital effects should be central, integrated, and
prominent in the agenda of CDC. It is important this not be neglected
as a cause of morbidity as well as mortality, nor that it be relegated
to an afterthought or ancillary problem. |
| 04/11/2005 |
07:49 |
PU |
238 |
D |
this
needs to be bottom up instead of top down.......We have already seen
duplicative projects funded at significantly higher cost our of the
OCSO. Specifically we are conducting two projects at 100K each that
OCSO funded a third at 1.5 million that overlaps both and duplicates
some previous work. |
| 04/08/2005 |
15:52 |
DC |
235 |
D |
I
was deeply troubled by both what CDC presented in the Centers for
Disease Control and Prevention Research Agenda Development Public
Participation Meeting as well as the information provided during the
meeting by the representatives of the Research Agenda Development
Workgroup (RADW). The leadership of this effort provided a wholly
inadequate discussion of the purpose or underlying objective of the
process or about public health is, as I understand it. I want to
comment on two critical areas where the information provided did not
suggest that the planners had a clear understanding of the need for the
agenda-setting process or the principles that underlay the effort.
For my part, I believe the CDC process would be best served if their
target of this effort was to propose or set research priorities for
public health not just for CDC. When the possible distinction was
raised in the public meeting between a) identifying CDC's research
priorities and b) the broader concern of identifying public health
research priorities, the response was something like, "Thank you for
your comment we will take this back with us." It was hard to hear this
as anything but a “brush-off”. Quite to the contrary, those
facilitating the meeting from the RADW should either have known the
answer and shared it or engaged the audience in a discussion of this
critical consideration. We still do not know which agenda is of
greatest concern to CDC and what leadership role, if any, CDC is
prepared to take concerning a research agenda for public health.
Secondly, in several different ways and at several different times
audience members raised a concern with the RADW objective asking
whether the task was a) to consider which ones of the various
division-specific research priorities (NORA is the one familiar to me
but we were told of many equivalents for other units) should become the
highest priorities for CDC (or public health), or b) to consider how
best to integrate the specific research priorities already identified
with CDC units into an overarching vision of research priorities.
Again, the response was "thank you for your comment we will take this
back with us." I was dismayed that the facilitators didn't know (or
share with us) which was the target or at least entertain a discussion
of which it should be.
|
| 04/08/2005 |
08:45 |
PU |
232 |
D |
Following
up on my comments in response to category 2, it seems that child
maltreatment, domestic violence & family violence doesn't clearly
fit into any of these categories. Also, where would adolescent sexual
health fit? |
| 04/08/2005 |
08:41 |
PU |
231 |
D |
The
list is too vague to be meaningful. It reads like a wish list with
subjects but no content. What is the time period? What is the budget?
What is the priority? What is the purpose? How does this "agenda"
differ from what CDC has done in the past? Who is this for? |
| 04/07/2005 |
19:03 |
PU |
227 |
D |
No comment |
| 04/07/2005 |
15:59 |
PU |
224 |
D |
Development
of a plan to capitalize on research that is generated in other federal
agencies/disciplines for use in specific CDC projects. For example, the
analysis of the utility of mental health and substance use research on
behavioral science specific to sexually-transmitted illnesses and risk
taking. |
| 04/07/2005 |
14:59 |
PU |
221 |
D |
Please
make UNDERAGE DRINKING AND DRUG USE one of your main topics. This focus
area would need to incorporate media messages, families, and colleges. |
| 04/07/2005 |
14:46 |
PU |
220 |
D |
In
several places, example research activities include "promote widespread
use of proven interventions..." How is "proven" defined in this
context? Does evaluating the "bang-for-the-buck" (e.g.,
cost-effectiveness) of the intervention come into play also? |
| 04/07/2005 |
10:20 |
PU |
210 |
D |
I
fell as though CDC is imposing what they think is best on communities
rather that acknowledging that effective strategies for disease
prevention and health promotion already exist but they need to be
submitted to rigorous scientific research in order to establish
validity. More attention to existing community strategies (social
networks for example) should be integrated into the overall CDC Health
Protection Research Guide, 2006-2015. In addition, there should be a
concerted effort to identify Centers that have already conducted this
research and take steps establish a resource center and/or conduct
research on adapting and tailoring existing protocols for different
diseases and/or populations |
| 04/07/2005 |
10:09 |
PU |
209 |
D |
I
do not see any agenda items here related specifically to access to
appropriate medical services, one of the core functions of public
health. There is a desperate need for research related to the care of
people with chronic conditions in this country -- availabilty of
family-centered palliative care, for example, when clients do not meet
the eligibility criteria for either skilled home health care or
hospice. The economic and social burden on families of providing care
to seniors, and the lack of training of those family members to provide
that care. |
| 04/07/2005 |
09:19 |
PU |
201 |
D |
If
we are going to be a shrinking organization, should I get out now?
Is the capital builty by CDC scientists being spent? Do we have group
think problems as were experienced by Intelligence? How do we spot
biased statistics? How do we remove bias at the top, as has embarassed
us with the smoking-obesity issue?
|
| 04/07/2005 |
09:11 |
PU |
200 |
D |
There
is no attention to disparities?..?? I would suggest that it should be
at the heart of public health and service delivery. “Social Inequality
May Be Harmful To Your Health. It Increases The Burden Of Disability
And Disease In Communities And Cuts Short Lives. Economic Deprivation,
Discrimination, Lack Of Access To Health Services, And Violation Or
Neglect Of Human Rights All Play A Part In Shaping Population Health.”
as cited on http://Www.Hsph.Harvard.Edu/Disparities
Health disparities research should be cross-cutting and should be based
on a goal of addressing and eliminating disparities; particulalry, as
it relates to policy, data & responsibility.
|
| 04/07/2005 |
08:45 |
PU |
198 |
D |
Provide
an intellectually stimulating environment for infectious disease
research, which includes an appriciation for sustained rigorous
scientific programs and professional development. Do not assume that a
small number of administrators have a better idea of the strengths of
the institution than do the combined intellect of the public health
scientists that have thought about this for most of their professional
lives.
The undeniable core component of the CDC remains understanding and
control of infectious disease. The 'disease control' role and goal is
completely understood and supported by the US public...many of the
other "priorities" listed in the document frequently don't merit the
term "research". |
| 04/07/2005 |
08:26 |
PU |
197 |
D |
Because
this is the first time someone has solicited my input, I am concerned
about your desire to have employee input. If you want everyone to buy
into something like this, they needed to be involved from the start;
otherwise, all you get is a rubber stamp on these extermely general
statements that seem to be all inclusive but really say very little. |
| 04/07/2005 |
07:53 |
PU |
192 |
D |
Where is the worksite health promotion agenda? I see worker safety, but not worksite health promotion. |
| 04/07/2005 |
06:45 |
PU |
190 |
D |
Branch
Chiefs and Division Directors are low enough in the chain to be aware
of priorities in their subject areas, yet should be aware of
priorities. Thesee should be consulted as well as those higher up the
chain who may be more aware of political priorities. |
| 04/07/2005 |
00:45 |
PU |
188 |
D |
Where
is the recognition that epidemiology is the key science that informs
CDC's decisions and research agenda? At one time, an entire CIO was
devoted to leadership and coordination of epidemiology agency-wide.
Where do we now turn for leadership in epidemiology? |
| 04/06/2005 |
08:53 |
DC |
179 |
D |
Much
needed guidelines, on prevention of transmission of infectious agents,
need to be backed by scientific evidence. Without that evidence (ie.
need for N95 respirators to prevent transmission of TB) other agencies
will pass regulations on a "feel good" basis giving false
information/security to the public and causing increased cost and
burden to the healthcare industry having to comply. |
| 04/05/2005 |
15:12 |
PU |
171 |
D |
Trauma
Centers serve to protect the nation’s health and need adequate funding.
Additional government funds must be allocated to save these vital
resources |
| 04/05/2005 |
14:18 |
PU |
165 |
D |
One
glaring gap in this agenda is the almost complete absence of items
addressing the role of social determinents of health in the etiology
and prevention of public health probrlems and of their promotion. This
has been widely recognized as an important frontier in wider public
health cricles and has been fostered within CDC. It is not addressed
within CDC's environmental health arena where attention is devoted
primarily to various aspects of the physical environment. Focussing
research attention on social determinents will help CDC devise
interventions that will have borader and longer lasting impact then
those that focus on individual behavior change. |
| 04/05/2005 |
13:45 |
PU |
164 |
D |
Trauma Center Preparedness |
| 04/04/2005 |
12:33 |
PU |
155 |
D |
I
believe that CDC is considering what its position should be on
developing standardized measures of clinical quality (in private
institutions; it is understood that it has a role in developing such
measures in public institutions)
I believe that CDC can play a role by helping promote evidence-informed
measurement, and discourage regulators, accrediting bodies, and others
from adding to the expensive and burdensome measurement demands by
adding measures that are not evidence-informed. |
| 04/04/2005 |
11:05 |
PU |
147 |
D |
I
like this web site and appreciate the opportunity to submit comments.
One overall comment I would like to make for the research agenda is
that each grant opportunity needs to focus on Community-Based
Participatory Research and Community Capacity Building. They're key
components for successful future research and not as prevalent as I
would like to see from govenment grant opportunities. |
| 04/04/2005 |
10:48 |
PU |
145 |
D |
Hello.
A research priority that is noticeably absent but a major health issue
is racial/ethnic disparities in health and health care. I would urge
the CDC to add this to the list and consider designing RFAs to address
this issue. Another priority that is missing but that would capitalize
on CDC strengths is community-based research. I would be happy to
discuss these issues further with a CDC project officer.
Thank you.
-Glenn Flores, MD
Director, Center for the Advancement of Underserved Children, Medical
College of Wisconsin, Milwaukee, WI |
| 04/03/2005 |
21:43 |
PU |
144 |
D |
i
found connections tot he problems individuals and society deals with on
a daily basis caused by the epedimic use of alcohol, tobacco and other
drugs. If babies dont' come into the world healthy but are affected by
FASD or other drug exposure, societies bill will mount dramatically as
the child ages. if the child becomes involved with alcohol under the
age of 14, the developmental delays and impairment will again cause
expense to the community and lost potential in the child. please do not
forget the role alcohol plays in many other diseases and public health
concerns. |
| 03/30/2005 |
10:37 |
DC |
131 |
D |
Frequent updates on where each of the 6 areas are in the process |
| 03/29/2005 |
14:18 |
OH |
117 |
D |
The
CDC Division of Oral Health (DOH), a component of the National Center
for Chronic Disease Prevention and Health Promotion (NCCDPHP), has
shared its list of Research Opportunities with the American Dental
Association. The Association regards oral health as an important area
for CDC-sponsored research, and is in full support of the topics
identified by the DOH. |
| 03/28/2005 |
14:56 |
DC |
104 |
D |
Recommend
strongly: the need for a National Healthcare-associated infection
reporting system that all states utilize, and a system whereby
consumers can understand the risk adjusted data generated from such a
system. This should be a National initiative, and not an individual
state initiative, in my opinion. |
| 03/28/2005 |
12:45 |
DC |
93 |
D |
I
would like to know, as a newly appointed Infection Control nurse, what
are the standards for staffing the Infection Control and Employee
Health Departments? I work in a 62 bed acute care facility and tackle
both the Infection Control and Employee Health jobs. Is this
recommended? |
| 03/28/2005 |
12:40 |
DC |
90 |
D |
Would
like to see Dr. Maki reconvene the HICPAC group to update CR-BSI . Much
good data on this was published only after the HICPAC group published
their guidelines. Please revise and update this guideline. |
| 03/28/2005 |
12:25 |
WA |
85 |
D |
I
was very impressed with your process. I attended the meeting on March
24th in Seattle. I think a list serve of public meeting participants
would be useful to you and a great vehicle to address updates. The
facilitator, Susan Veit, in the Environmental and Occupational Health
breakout session was superb. |
| 03/28/2005 |
11:48 |
DC |
82 |
D |
I recommend CDC research agenda be evaluated no less frequently than every 4-5 years. |
| 03/28/2005 |
11:05 |
DC |
75 |
D |
I
think that there are so many different approaches to decreasing
healthcare acquired infections from so many different agencies that we
are just chasing our tails to meet all these different agency
requirements. It seems everyone is looking at the same issues, but just
a little differently. This leads to great frustration when we look at
pneumonia 4 different ways and try to meet 4 different agency
expectations. This leads to poor interventions. We need the CDC to lead
the way on best practice and if we meet CDC requirements, we meet
JCAHO, CMS, etc. |
| 03/22/2005 |
20:50 |
OH |
39 |
D |
The
CDC web site states "CDC remains committed to supporting the Healthy
People 2010 goals. We think that those goals will play a vital role as
we move forward with agencywide goals management at CDC. In many
instances, the Healthy People 2010 goals clearly define particular
strategies and interventions that can be used to drive CDC’s health
impact goals which are framed in terms of life stages, healthy
communities, and community preparedness." However, several key areas
from HP 2010 are missing - infant health, and cancer. I do not
understand how CDC will support HP 2010 goals if they are not listed.
|
| 03/16/2005 |
11:19 |
WA |
31 |
D |
I'd
like to register but this is the only page that comes up. Please let me
know how to register for the Seattle meeting. Katrina.Simmons@doh.wa.gov |
| 03/11/2005 |
16:04 |
WA |
20 |
D |
Please secure a larger room for the session on Environmental Health |
| 03/11/2005 |
07:02 |
GA |
18 |
D |
Utilize community participatory reserarch
Publicize research priorities |
| 02/23/2005 |
18:08 |
GA |
4 |
D |
I
cannot comment without knowing more about the directions for research
in these broad areas. The areas themselves seem to be a reasonable
breakdown of the whole, though I am concerned that the area of health
promotion research appears to have little space for such behavioral and
lifestyle issues as tobacco use, poor nutrition and physical
inactivity. I trust the conference will offer greater insight on the
directions in these broad areas. In addition, I am interested to know
how these CDC research initiatives intersect with the larger research
agendas at NIH, AHRQ and other federal agencies. |
| Back
to Top |
|
