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Impact Of The Introduction Of Pneumococcal Conjugate Vaccine On Immunization Coverage Among Infants, Nancy D. Lin, Ken Kleinman, K Arnold Chan, Xian-Jie Yu, Eric K. France, Stanley Xu, Feifei Wei, John Mullooly, Jeanne Santoli, Tracey A. Lieu, Vaccine Safety Datalink Group

Public Health Department Faculty Publication Series

Background

The introduction of pneumococcal conjugate vaccine (PCV) to the U.S. recommended childhood immunization schedule in the year 2000 added three injections to the number of vaccinations a child is expected to receive during the first year of life. Surveys have suggested that the addition of PCV has led some immunization providers to move other routine childhood vaccinations to later ages, which could increase the possibility of missing these vaccines. The purpose of this study was to evaluate whether introduction of PCV affected immunization coverage for recommended childhood vaccinations among 13-month olds in four large provider groups.

Methods

In this …

Maternal Fish Consumption, Hair Mercury, And Infant Cognition In A U.S. Cohort., Ken Kleinman, Emily Oken, Robert Wright, David Bellinger, Chitra Amarasiriwardena, Howard Hu, Janet Rich-Edwards, Matthew Gillman

Public Health Department Faculty Publication Series

Fish and other seafood may contain organic mercury but also beneficial nutrients such as n-3 polyunsaturated fatty acids. We endeavored to study whether maternal fish consumption during pregnancy harms or benefits fetal brain development. We examined associations of maternal fish intake during pregnancy and maternal hair mercury at delivery with infant cognition among 135 mother–infant pairs in Project Viva, a prospective U.S. pregnancy and child cohort study. We assessed infant cognition by the percent novelty preference on visual recognition memory (VRM) testing at 6 months of age. Mothers consumed an average of 1.2 fish servings per week during the second …

Longitudinal Study Of Birth Weight And Adult Body Mass Index In Predicting Risk Of Coronary Heart Disease And Stroke In Women, Ken Kleinman, Janet Rich-Edwards, Karin Michels, Meir Stampfer, Joann Manson, Kathryn Rexrode, Eileen Hibert, Walter Willett

Public Health Department Faculty Publication Series

Objectives To determine whether birth weight and adult body size interact to predict coronary heart disease in women, as has been observed for men. To determine whether birth weight and adult body size interact to predict risk of stroke.

Design Longitudinal cohort study.

Setting and participants 66 111 female nurses followed since 1976 who were born of singleton, term pregnancies and reported their birth weight in 1992.

Main outcome measures 1504 events of coronary heart disease (myocardial infarction or sudden cardiac death) and 1164 strokes.

Results For each kilogram of higher birth weight, age adjusted hazard ratios from prospective analysis …

Group Versus Individual Academic Detailing To Improve The Use Of Antihypertensive Medications In Primary Care: A Cluster-Randomized Controlled Trial, Steven R. Simon, Sumit R. Majumdar, Lisa A. Prosser, Susanne Salem-Schatz, Cheryl Warner, Ken Kleinman, Irina Miroshnik, Stephen B. Soumerai

Public Health Department Faculty Publication Series

Purpose

To compare group versus individual academic detailing to increase diuretic or β-blocker use in hypertension.

Methods

We conducted a cluster-randomized controlled trial in a large health maintenance organization. Subjects (N=9820) were patients with newly treated hypertension in the year preceding the intervention (N=3692), the 9 months following the intervention (N=3556), and the second year following intervention (N=2572). We randomly allocated 3 practice sites to group detailing (N=227 prescribers), 3 to individual detailing (N=235 prescribers), and 3 to usual care (N=319 prescribers). Individual detailing entailed a physician-educator meeting individually with clinicians to address barriers to prescribing guideline-recommended medications. The group …