Background: Congenital diaphragmatic hernia (CDH) occurs when abnormal diaphragm development allows herniation of abdominal organs into the thoracic cavity. Its etiopathogenesis is not well understood, but cigarette smoking and alcohol exposure may impact diaphragm development. Using data from a large, population-based case-control study, we examined associations between maternal cigarette smoking and alcohol consumption and CDH in offspring.Methods: We analyzed maternal interview reports of cigarette smoking and alcohol consumption during early pregnancy for 831 children with CDH and 11,416 children without birth defects with estimated dates of delivery during 1997-2011. Generalized linear mixed effects models with a random intercept for study site were used to estimate associations between measures of exposure to smoking (any, type, frequency, duration) and alcohol (any, quantity, frequency, variability, type) for all CDH combined and selected subtypes (Bochdalek and Morgagni).Results: Mothers of 280 (34.0%) case and 3,451 (30.3%) control children reported early pregnancy exposure to cigarette smoking. Adjusted odds ratios Julia Finn and Jonathan Suhl contributed equally to this study.
Limited information exists about social network variation and health information sharing during COVID-19, especially for Native Hawaiians (NH), Other Pacific Islanders (OPI), and Filipinos, who experienced COVID-19 inequities. Hawai’i residents aged 18–35 completed an online survey regarding social media sources of COVID-19 information and social network health information measured by how many people participants: (1) talked to and (2) listened to about health. Regression models were fit with age, gender, race/ethnicity, chronic disease status, pandemic perceptions, and health literacy as predictors of information sources (logistic) and social network size (Poisson). Respondents were 68% female; 41% NH, OPI, or Filipino; and 73% conducted a recent COVID-19 digital search for themselves or others. Respondents listened to others or discussed their own health with ~2–3 people. Respondents who talked with more people about their health were more likely to have larger networks for listening to others. In regression models, those who perceived greater risk of acquiring COVID-19 discussed their health with more people; in discussing others’ health, women and those with chronic diseases listened to a greater number. Understanding young adults’ social networks and information sources is important for health literacy and designing effective health communications, especially to reach populations experiencing health inequities.
Objectives: Overnight camps are a setting where COVID-19 can easily spread without the diligent use of layered public health interventions. We evaluated 20 camps in the United States to examine COVID-19 transmission and mitigation strategies during summer 2021. Methods: For this descriptive cross-sectional study, we examined self-reported information from 20 camps in 6 predominantly northeastern states on geographic information, tests and testing cadences, vaccination rates, and number of COVID-19 cases during summer 2021. Because the camps had hired public health consultants to guide them on reducing COVID-19 introduction and spread, all camps implemented similar interventions, including encouraging behaviors that lower the risk of COVID-19 transmission prior to camp arrival, use of cohorts, testing before and after arrival, and strong encouragement of vaccination among eligible campers and staff members. Results: A total of 9474 attendees at the 20 camps came from geographically diverse regions. Camps generally tested before and at arrival, as well as once or twice after arrival. Rates of vaccination were high among staff members (84.6%) and campers (76.2%). Camps identified 27 COVID-19 cases, with 17 (63.0%) detected after arrival, 3 (7.4%) detected on arrival, and 8 (29.6%) detected prior to arrival. Conclusions: The spread of cases detected after arrival to overnight camps was limited by the use of 3 key interventions: (1) high vaccination rates, (2) a rigorous and responsive testing strategy, and (3) ongoing use of public health interventions. These findings have implications for successful operation of overnight camps, residential schools and colleges, and other similar settings.
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