Few large epidemiological studies have examined the co-occurrence of autism and asthma. We performed a cross-sectional study to examine this association using the 2007 National Survey of Children's Health dataset (n = 77,951). We controlled for confounders and tested for autism-secondhand smoke interaction. Prevalence of asthma and autism were 14.5 % (n = 11,335) and 1.81 % (n = 1,412) respectively. Unadjusted odds ratio (OR) for asthma among autistic children was 1.35 (95 % CI 1.18-1.55). Adjusting for covariates (age, gender, body mass index, race, brain injury, secondhand smoke and socio-economic status) attenuated the OR to 1.19 (95 % CI 1.03-1.36). Autism-secondhand smoke interaction was insignificant (p = 0.38). Asthma is approximately 35 % more common in autistic children; screening may be an efficient approach to reduce risk of morbidity due to asthma.

Elevated blood lead levels were reduced with increasing length of time of resettlement in unadjusted and adjusted models. Improved housing, early education, and effective safe-house inspections may be necessary to address EBLLs in refugees.

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Background and purpose Patients undergoing splenectomy for trauma are at life‐long risk for rapidly progressive septicemia. The purpose of this study was to investigate long‐term patient understanding and follow‐up with recommendations regarding their asplenia. Methods Patients undergoing splenectomy for trauma January 2010–December 2014 were analyzed. Medical records were reviewed and telephone follow‐up interviews were conducted in October–December 2015. Patients were asked a standard set of questions that included hospitalizations, awareness of infectious risks associated with asplenia, need for revaccination, and vaccines they had received since their index hospitalization. Findings Two hundred forty‐four patients underwent splenectomy during the study period. A total of 95 patients (39%) were included in the study. Thirty (32%) had been hospitalized since their trauma admission. Only 46% were aware of the risks for sepsis and the need to revaccinate. Only 7% reported having rapid access to antibiotics. Conclusions Despite uniform education prior to discharge, most patients undergoing splenectomy for trauma were unaware of the risks for sepsis and did not follow recommended guidelines for risk reduction. Implications for practice Improvements that have direct implications for advanced practice included the need to refer for vaccination, educate regarding infection risks, and facilitate rapid access to antibiotic treatment.

Objectives: Refugees resettling in the United States bring with them a number of health conditions, the majority chronic. These health conditions may impact their ability to be successful with disease self-management and employment, and acculturate and thrive in their new communities. Knowledge of health conditions present in individual refugee populations can be of benefit to healthcare providers in the community and public health. The objective of this manuscript is to describe the state of health among refugees newly arriving in the US and resettling in Kentucky during 2016. Methods: Using data from the domestic health screens, immunization clinics, and the Centers for Disease Control and Prevention Electronic Disease Notification, a database entitled Arriving Refugee Informatics Surveillance and Epidemiology (ARIVE) was developed and the Research Electronic Data Capture (REDCap) system used as the platform. Results: A total of 1495 adult and pediatric refugees were screened during January-June 2016 in Louisville, Lexington, Owensboro, and Bowling Green, Kentucky and data entered into ARIVE. Results from those domestic health screenings identified dental abnormalities (60%), obesity (23%), decreased visual acuity (14%), hyperlipidemia (14%), and elevated blood lead levels in child refugees (12%). Latent tuberculosis infection was identified in 13% and more than 32% had evidence of at least one intestinal parasite. Conditions of social importance included tobacco use among 16%. Mental health issues were evident as 15% had a positive Refugee Health Screener (RHS-15) result and more than 13% indicated they had witnessed or experienced torture. Conclusions: This analysis shows that the main health conditions facing refugees after arriving in the US are chronic conditions that require long-term medical management and support services. Upon review of these results, a systematic approach to solving the problem of long-term followup needs to be established for refugees in order to address and decrease the impact of chronic health conditions. Using information from this Kentucky assessment may promote interest in a national refugee health database as a means of developing population-based and populationspecific interventions to improve overall health.