Particle Size, Dose, and Confinement Affect Passive Diffusion Flux through the Membrane Concentration Boundary Layer.

The authors present a steady-state-, particle-size-, and dose-dependent dissolution-permeation model that describes particle dissolution within the concentration boundary layer (CBL) adjacent to a semipermeable surface. It is critical to understand how particle size and dose affect the behavior of dissolving particles in the presence of a CBL adjacent to a semipermeable surface both and . Control of particle size is ubiquitous in the pharmaceutical industry; however, traditional pharmaceutical assumptions of particle dissolution typically ignore particle dissolution within the length scale of the CBL.

Ultrathin, Large-Area Membrane Diffusion Cell for pH-Dependent Simultaneous Dissolution and Absorption Studies.

Preclinical evaluation of modern oral dosage forms requires more advanced in vitro devices as the trend of selecting low solubility, high permeability compounds for commercial development continues. Current dissolution methodologies may not always be suitable for such compounds due to excessive fluid volume, high fluid shear rates, heterogeneity of shear rates, suboptimal fluid flow, and, ultimately, the lack of absorption ability (Gray The Science of USP 1 and 2 Dissolution: Present Challenges and Future Relevance; , 2009; Vol. 26; pp 1289-1302).

Neighborhood socioeconomic characteristics, healthcare spatial access, and emergency department visits for ambulatory care sensitive conditions for elderly.

The objective of this study is to explore relationships among neighborhood socioeconomic characteristics (for example, income and ethnicity), spatial access to health care, and emergency department (ED) visits for ambulatory care sensitive conditions (ACSC) for adults aged 65 years and over. ED visit data were from 15 counties in the Texas Coastal Bend from September 1, 2009 and August 1, 2012. ED visits for ACSC that were common for elderly were estimated based on Agency for Healthcare Research and Quality's (AHRQ's) ACSC and Prevention Quality Indicators.

Training Public Health Advisors.

Federal public health advisors provide guidance and assistance to health departments to improve public health program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering public health programs. This article describes the evolving training and is based on internal CDC documents and interviews.

Conclusion and future directions: CDC Health Disparities and Inequalities Report - United States, 2013.

The reports in this supplement document persistent disparities between some population groups in health outcomes, access to health care, adoption of health promoting behaviors, and exposure to health-promoting environments. Some improvements in overall rates and even reductions in some health disparities are noted; however, many gaps persist. These finding highlight the importance of monitoring health status, outcomes, behaviors, and exposures by population groups to assess trends and target interventions.

Introduction: CDC Health Disparities and Inequalities Report - United States, 2013.

This supplement is the second CDC Health Disparities and Inequalities Report (CHDIR). The 2011 CHDIR was the first CDC report to assess disparities across a wide range of diseases, behavioral risk factors, environmental exposures, social determinants, and health-care access (CDC. CDC Health Disparities and Inequalities Report-United States, 2011.

Risk factors associated with clinic visits during the 1999 forest fires near the Hoopa Valley Indian Reservation, California, USA.

Forest fires burned near the Hoopa Valley Indian Reservation in northern California from late August until early November in 1999. The fires generated particulate matter reaching hazardous levels. We assessed the relationship between patients seeking care for six health conditions and PM(10) exposure levels during the 1999 fires and during the corresponding period in 1998 when there were no fires.

Trends in blood lead levels and blood lead testing among US children aged 1 to 5 years, 1988-2004.

Objectives: To evaluate trends in children's blood lead levels and the extent of blood lead testing of children at risk for lead poisoning from national surveys conducted during a 16-year period in the United States.

Methods: Data for children aged 1 to 5 years from the National Health and Nutrition Examination Survey III Phase I, 1988-1991, and Phase II, 1991-1994 were compared to data from the survey period 1999-2004.

Results: The prevalence of elevated blood lead levels, >/=10 microg/dL, among children decreased from 8.

Screening for lead poisoning: a geospatial approach to determine testing of children in at-risk neighborhoods.

Objective: To develop a spatial strategy to assess neighborhood risk for lead exposure and neighborhood-level blood lead testing of young children living in the city of Atlanta, Georgia.

Study Design: This ecologic study used existing blood lead results of children aged View Article and Find Full Text PDF

Reduction of elevated blood lead levels in children in North Carolina and Vermont, 1996-1999.

Background: Few studies have examined factors related to the time required for children's blood lead levels (BLLs) > or = 10 microg/dL to decline to < 10 microg/dL.

Objectives: We used routinely collected surveillance data to determine the length of time and risk factors associated with reducing elevated BLLs in children below the level of concern of 10 microg/dL.

Methods: From the North Carolina and Vermont state surveillance databases, we identified a retrospective cohort of 996 children < 6 years of age whose first two blood lead tests produced levels > or = 10 microg/dL during 1996-1999.

Global approach to reducing lead exposure and poisoning.

Lead poisoning is an important environmental disease that can have life-long adverse health effects. Most susceptible are children, and most commonly exposed are those who are poor and live in developing countries. Studies of children's blood-lead levels (BLLs) are showing cognitive impairment at increasingly lower BLLs.

Use of the ABC care bundle to standardize guideline implementation in a cardiac surgical population: a pilot study.

A cardiac surgical progressive care unit implemented the ABC's of Cardiovascular Risk Reduction Care Bundle to determine whether the use of a packaged approach to medication prescription and lifestyle counseling would improve adherence to secondary risk-reduction guidelines in postcoronary artery bypass graft patients. A pilot study was carried out to assess changes in adherence to guideline recommendations post-Care Bundle implementation. Findings support using a systematic strategy to improve guideline adherence in this population.

Identifying housing that poisons: a critical step in eliminating childhood lead poisoning.

The purpose of our study was to develop a method to identify and prioritize "high-risk" buildings in Chicago that could be targeted for childhood lead poisoning prevention activities. We defined "high-risk" buildings as those where multiple children younger than 6 years with elevated blood lead levels (BLLs) had lived and where lead hazards were previously identified on environmental inspection. By linking 1997-2003 Chicago elevated blood lead surveillance, environmental inspection, and building footprint data, we found that 49,362 children younger than 6 years with elevated BLLs lived at 30,742 buildings.

Binational study of pediatric blood lead levels along the United States/Mexico border.

To evaluate lead exposure among children living in border communities, the states of Arizona and New Mexico in the United States (US), and the states of Sonora and Chihuahua in Mexico collaboratively requested that the Centers for Disease Control and Prevention (CDC) provide technical assistance to document pediatric blood lead levels (BLLs) in children living along this part of the US/Mexico border. Two studies were conducted to evaluate BLLs of children aged 1-6 years. In 1998, 1210 children were tested in the Arizona/Sonora study; in 1999, 874 children were tested in New Mexico/Chihuahua.

Blood lead levels and risk factors for lead poisoning in children and caregivers in Chuuk State, Micronesia.

Lead poisoning is a preventable environmental disease. Children and developing fetuses are especially vulnerable; even low blood lead levels (BLLs) are linked with learning and behavioral problems. We assessed children's and their caregivers' BLLs and risk factors for lead exposure in Chuuk State, Federated States of Micronesia.

Improving strategies to prevent childhood lead poisoning using local data.

Lead poisoning remains an important, yet entirely preventable, disease among children worldwide. Children's blood lead levels (BLLs) have been declining in the United States; however, nearly half a million children have BLLs > or = 10 microg/ dl, the level targeted for elimination by 2010. Attainment of this national goal will require translating knowledge into public health practice.

A federal agency's role in fulfilling the public health core functions: the childhood lead poisoning prevention program model.

The Institute of Medicine identified 3 core functions of public health: assessment, policy development, and assurance. Federal, state, and local public health agencies all have an obligation to provide these vital functions to ensure conditions in which people can be healthy. However, the few publications that provide core function applications only focus on applications at the local or state levels.

High-intensity targeted screening for elevated blood lead levels among children in 2 inner-city Chicago communities.

Objectives: We assessed the prevalence of elevated blood lead levels (> or = 10 micrograms of lead per deciliter of blood), risk factors, and previous blood lead testing among children in 2 high-risk Chicago, Ill, communities.

Methods: Through high-intensity targeted screening, blood lead levels were tested and risks were assessed among a representative sample of children aged 1 to 5 years who were at risk for lead exposure.

Results: Of the 539 children who were tested, 27% had elevated blood lead levels, and 61% had never been tested previously.

Surveillance for elevated blood lead levels among children--United States, 1997-2001.

Problem/condition: Lead is neurotoxic and particularly harmful to the developing nervous systems of fetuses and young children. Extremely high blood lead levels (BLLs) (i.e.

A global approach to childhood lead poisoning prevention.

Childhood lead poisoning is an important, preventable environmental disease affecting millions of children around the world. The effects of lead are well known and range from delayed and adversely affected neurodevelopment to severe health outcomes including seizures, coma, and death. This article reviews the childhood effects of lead poisoning, the approach being taken to the problem in the United States, and the obstacles faced by developing nations in dealing with lead exposure.

Characteristics of adults dying with COPD.

Study Objective: To describe factors associated with COPD deaths in the United States.

Design: Cross-sectional survey.

Participants: A total of 12,803 decedents in the National Mortality Followback Survey, a nationally representative sample of US deaths in 1993.

How useful are CBC and reticulocyte reports to clinicians?

We surveyed 1,353 attending and 689 house staff physicians of the University Hospitals of Cleveland to ascertain the parameters of the CBC, leukocyte differential, and reticulocyte reports perceived as useful in clinical practice. The response rate was 33% for attending and 22% for house staff physicians. Only 4 of 11 parameters routinely reported in the CBC battery were selected as frequently or always useful by more than 90% of physicians: hemoglobin, hematocrit, platelet count, and WBC count.

Wildland forest fire smoke: health effects and intervention evaluation, Hoopa, California, 1999.

Objectives: To assess the health effects of exposure to smoke from the fifth largest US wildfire of 1999 and to evaluate whether participation in interventions to reduce smoke exposure prevented adverse lower respiratory tract health effects among residents of the Hoopa Valley National Indian Reservation in northwestern California.

Design: Observational study: epidemiologists from the Centers for Disease Control and Prevention retrospectively reviewed medical records at the local medical center and conducted survey interviews of reservation residents.

Setting: Humboldt County, California.