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San Diego Needle Exchange Program Examined
KPBS profiled San Diego"s "only clean syringe exchange program," a mobile van that twice weekly provides injection drug users with clean needles in exchange for used ones. The program also offers HIV and Hepatitis C tests and gives referrals to drug treatment programs. According to KPBS, "The concept behind syringe exchange is simple: people are going to shoot drugs. It"s crucial to make sure they have access to clean equipment, so they don"t spread blood-borne infections." However, the San Diego County Board of Supervisors is "adamantly opposed to the concept," and it is "illegal in San Diego for people to buy clean needles without a prescription," KPBS reports. In 2008, the privately-funded exchange program, which has the support of the mayor and the city council, collected more than 183,000 used syringes and handed out about 172,000 new ones (Goldberg, 7/7).
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NICE Guideline Helps End Regional Variation Of Access To Fertility Treatment, UK
The number of local health services implementing NICE"s fertility guideline and offering three cycles of IVF treatment to couples who are unable to conceive naturally has increased significantly in the past year, according to a new survey published by the Department of Health. According to these new figures, more than a quarter of primary care trusts now offer the full number of cycles recommended by NICE- this figure is up from five per cent in 2007.
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White House Emphasizes Need To Reduce Health Care Costs, Improve Access To Care Among Blacks
During a White House teleconference last week, Nancy-Ann DeParle, director of the White House Office on Health Reform said that reducing health care costs is "particularly important for the [black] community because on average, they spend a higher percentage of their income on health care costs, compared to their white counterparts," the Washington Informer reports. Nancy-Ann DeParle, director of the office, at a press conference last week said that reducing health care costs is "particularly important for the [black] community because on average, they spend a higher percentage of their income on health care costs, compared to their white counterparts." She added that blacks spend about 16.5% of their income on health care, while whites spend about 12%. In addition, blacks "continue to face disparities in terms of the (quality of care) they get," DeParle said. According to DeParle, blacks tend to visit hospitals that "provide lower-quality care." She added that higher health care costs are "especially troubling" to the black community because blacks "suffer from higher percentages of chronic diseases such as heart disease, kidney disease and diabetes, that are due in part to a lack of access to quality care."According to the Informer, $1 billion of the $787 billion stimulus package that President Obama signed in February will be allocated to prevention efforts and public health campaigns (Michaels, Washington Informer, 5/21).
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Children Denied Immunizations At Increased Risk Of Whooping Cough

Children of parents who refuse vaccines are 23 times more likely to get whooping cough compared to fully immunized children, according to a new study led by a vaccine research team at Kaiser Permanente Colorado"s Institute for Health Research. The study will appear in the June 2009 issue of the journal Pediatrics, the journal of the American Academy of Pediatrics. Funded by the National Institute of Allergy and Infectious Diseases, this is the first study to use electronic health records to look for immunization refusal and possible pertussis infections, making it the most definitive on the risk of vaccine refusal to date. While most families vaccinate their children, leading to dramatic reductions in several serious childhood illnesses, the number of parents refusing immunizations appears to be increasing in the United States, researchers say. The study could not determine from the information available why parents elected to refuse vaccines. The study also did not evaluate the side effects of vaccines. The study findings are important for parents who cite low risk of infection as a reason to choose fewer or no immunizations, and for researchers who are concerned that decreased immunization rates could lead to more disease outbreaks across the country. "This study helps dispel one of the commonly held beliefs among vaccine-refusing parents: that their children are not at risk for vaccine preventable diseases," said study lead author Jason Glanz, Ph.D., a senior scientist at Kaiser Permanente"s Institute for Health Research. "It also shows that the decision to refuse immunizations could have important ramifications for the health of the entire community. Based on our analysis, we found that one in 10 additional whooping cough infections could have been prevented by immunization." Pertussis - more commonly known as whooping cough - is a highly contagious bacterial disease that causes uncontrollable, violent coughing and can be deadly in infants, especially those under two months of age who are too young to be fully vaccinated. In 1976 there were just over 1,000 reported cases of pertussis in the United States; by 2004, it climbed to nearly 26,000 cases. Between 2000 and 2005 there were 140 deaths resulting from pertussis in the United States. The best way to prevent pertussis is through vaccinations. The childhood vaccine, DTaP, is a "3-in-1" immunization that protects against diphtheria, pertussis, and tetanus. It is given in a series to children at two months, four months, six months and 15-18 months of age, and a booster is given before kindergarten. The DTaP vaccine, like other routine childhood immunizations, has been shown to be more than 98 percent effective. To assess the risk of DTaP refusal, researchers reviewed the electronic health records of children between the ages of two months and 18 years who were members of Kaiser Permanente Colorado between 1996 and 2007. First, investigators confirmed which children had pertussis infections. Next, they verified whether parents had refused some or all vaccines for their children. The researchers found 156 laboratory-confirmed pertussis cases that met the study"s criteria. They compared these cases to four times as many children of the same age and gender who were not infected with pertussis. Based on this analysis, the researchers discovered that children of vaccine refusers were 23 times more likely to be infected with whooping cough than vaccinated children. "As a father of young children, I understand that vaccines can pose confusing and difficult choices, so the purpose of this research is to give parents more information to weigh the benefits and risks, and to provide pediatricians with more information to help participate in the discussion," Glanz said. According to pediatrician and co-author Matthew F. Daley, MD, of The Children"s Hospital Denver and Kaiser Permanente"s Institute for Health Research: "Parents want to do what is best for their children and need information to make good decisions regarding immunizations. This study will benefit parents and pediatric health care providers because it helps us better understand some of the risks of not vaccinating against childhood diseases." Additional study authors include: David L. McClure, Ph.D., David J. Magid, MD, MPH, and Simon J. Hambidge, MD, Ph.D., of the Kaiser Permanente Institute for Health Research; Eric K. France, MD, MSPH, of the Department of Pediatrics, Kaiser Permanente Colorado; Daniel A. Salmon, Ph.D., MPH of the Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University. Danielle Cass Kaiser Permanente


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