bluuebunny/crossref_metadata_2025_split huggingface dataset:
Providing Mailing Cost Reimbursements: The Effect on Reporting Timeliness of Sexually Transmitted Diseases in Virginia
Authors: Vasiliu Oana E. , Stover Jeffrey A. , Mays Marissa J. E. , Bissette Jennifer M. , Dolan Carrie B. , Sirbu Corina M. 
Published: July 2017

Objectives. We investigated the effect of providing mailing cost reimbursements to local health departments on the timeliness of the reporting of sexually transmitted diseases (STDs) in Virginia. Methods. The Division of Disease Prevention, Virginia Department of Health, provided mailing cost reimbursements to 31 Virginia health districts from October 2002 to December 2004. The difference (in days) between the diagnosis date (or date the STD paperwork was initiated) and the date the case/STD report was entered into the STD surveillance database was used in a negative binomial regression model against time (as divided into three periods—before, during, and after reimbursement) to estimate the effect of providing mailing cost reimbursements on reporting timeliness. Results. We observed significant decreases in the number of days between diagnosis and reporting of a case, which were sustained after the reimbursement period ended, in 25 of the 31 health districts included in the analysis. We observed a significant initial decrease (during the reimbursement period) followed by a significant increase in the after-reimbursement phase in one health district. Two health districts had a significant initial decrease, while one health district had a significant decrease in reporting timeliness in the period after reimbursement. Two health districts showed no significant changes in the number of days to report to the central office. Conclusion. Providing reimbursements for mailing costs was statistically associated with improved STD reporting timeliness in almost all of Virginia's health districts. Sustained improvement after the reimbursement period ended is likely indicative of improved local health department reporting habits.
Not Enough Fruit and Vegetables or Too Many Cookies, Candies, Salty Snacks, and Soft Drinks?
Authors: Cohen Deborah A. , Sturm Roland , Scott Molly , Farley Thomas A. , Bluthenthal Ricky 
Published: July 2017

Objectives. There are many contributors to obesity, including excess consumption of “discretionary calories” (foods high in sugar and fat and low in essential nutrients), lack of fruit/vegetable consumption, and insufficient physical activity. This study contrasted physical activity, fruit/vegetable consumption, and discretionary calorie consumption from selected foods relative to the 2005 dietary guidelines. Methods. We conducted a cross-sectional survey in 228 urban census tracts in Los Angeles County (LAC) and Southern Louisiana (SL) and estimated calories in the past 24 hours from fruit, vegetables, cookies, candy, salty snacks, sweetened soda, and alcohol among 2,767 participants. Results. The population-weighted mean daily intake of calories from candy, cookies, salty snacks, soda, and alcohol was 438 in LAC and 617 in SL. Alcohol comprised a small portion of the calories consumed. Reported discretionary calorie consumption from a small set of items exceeded guidelines by more than 60% in LAC and 120% in SL. In contrast, the mean consumption of fruit and vegetables fell 10% short in LAC and 20% in SL. There was significant heterogeneity in consumption of cookies, candy, salty snacks, and soda across income, gender, and race. Conclusions. The overconsumption of discretionary calories was much greater than the underconsumption of fruit and vegetables. This finding suggests that unless the excessive consumption of salty snacks, cookies, candy, and sugar-sweetened beverages is curtailed, other interventions focusing on increasing physical activity and fruit and vegetable consumption will have a limited impact on obesity control. It may be politically more expedient to promote an increase in consumption of healthy items rather than a decrease in consumption of unhealthy items, but it may be far less effective.
Evaluating Real-Time Syndromic Surveillance Signals from Ambulatory Care Data in Four States
Authors: Yih W. Katherine , Deshpande Swati , Fuller Candace , Heisey-Grove Dawn , Hsu John , Kruskal Benjamin A. , Kulldorff Martin , Leach Michael , Nordin James , Patton-Levine Jessie , Puga Ella , Sherwood Edward , Shui Irene , Platt Richard 
Published: July 2017

Objectives. We evaluated a real-time ambulatory care-based syndromic surveillance system in four metropolitan areas of the United States. Methods. Health-care organizations and health departments in California, Massachusetts, Minnesota, and Texas participated during 2007–2008. Syndromes were defined using International Classification of Diseases, Ninth Revision diagnostic codes in electronic medical records. Health-care organizations transmitted daily counts of new episodes of illness by syndrome, date, and patient zip code. A space-time permutation scan statistic was used to detect unusual clustering. Health departments followed up on e-mailed alerts. Distinct sets of related alerts (“signals”) were compared with known outbreaks or clusters found using traditional surveillance. Results. The 62 alerts generated corresponded to 17 distinct signals of a potential outbreak. The signals had a median of eight cases (range: 3–106), seven zip code areas (range: 1–88), and seven days (range: 3–14). Two signals resulted from true clusters of varicella; six were plausible but unconfirmed indications of disease clusters, six were considered spurious, and three were not investigated. The median investigation time per signal by health departments was 50 minutes (range: 0–8 hours). Traditional surveillance picked up 124 clusters of illness in the same period, with a median of six ill per cluster (range: 2–75). None was related to syndromic signals. Conclusions. The system was able to detect two true clusters of illness, but none was of public health interest. Possibly due to limited population coverage, the system did not detect any of 124 known clusters, many of which were small. The number of false alarms was reasonable.
Viral Hepatitis and Injection Drug Use in Appalachian Kentucky: A Survey of Rural Health Department Clients
Authors: Christian W. Jay , Hopenhayn Claudia , Christian Amy , McIntosh Deana , Koch Alvaro 
Published: July 2017

Objectives. We identified correlates of exposure to hepatitis B and C viruses among health department clients in Appalachian Kentucky, a rural region noted for high poverty and low education. Additionally, we investigated risk factors for transmission, and the frequency of use of preventive measures. Methods. Patients screened for hepatitis B or C at four county health departments in Appalachian Kentucky were administered a routine prescreening questionnaire and an additional survey designed to obtain detailed personal and behavioral risk factor data. These data were linked to produce a more comprehensive dataset for analysis, including test results, which were attached to the prescreening questionnaire. Results. In total, 92 health department clients participated in the study survey. Of these, test results were available for 80 of the clients. Very few subjects who enrolled in this study tested positive for hepatitis B. Twelve out of 80 participants (15%) tested positive for previous exposure to hepatitis C. No participants reported having human immunodeficiency virus. Conclusions. Transmission of hepatitis C in these rural Appalachian communities is predominantly due to injection drug use. Patients with hepatitis C exposure are similar in their demographic and risk profiles as those seen in urban areas and, despite small numbers, can have a serious impact on small, rural public health systems.
The Positive Role of Social Networks and Social Networking Technology in the Condom-Using Behaviors of Homeless Young People
Authors: Rice Eric 
Published: July 2017

Objective. To examine the impact of condom-using peers in the social networks of homeless young people, differences in behaviors were assessed based on the social location of ties (home-based vs. street-based) and how those ties are maintained (face-to-face vs. via social networking technology). Methods. “Ego-centric” social network data were collected from 103 currently sexually active homeless young people aged 16–26 years in Los Angeles, California. Associations between condom use and the condom-using behaviors of social network influences were assessed using standard logistic regression. Results. About 52% of respondents had a street-based peer who was a condom user. Having such a peer was associated with a 70% reduction in the odds of having unprotected sex at last intercourse. About 22% of respondents had a condom-using, home-based peer with whom they communicated only via social networking technology. Having such a peer was associated with a 90% reduction in risky sexual behavior and a 3.5 times increase in safer sex behavior. Conclusion. The study revealed several implications for new human immunodeficiency virus-prevention interventions that mobilize these networks and social networking technologies.
Informing Faith-Based HIV/AIDS Interventions: HIV-Related Knowledge and Stigmatizing Attitudes at Project F.A.I.T.H. Churches in South Carolina
Authors: Lindley Lisa L. , Coleman Jason D. , Gaddist Bambi W. , White Jacob 
Published: July 2017

Objectives. Project F.A.I.T.H. (Fostering AIDS Initiatives that Heal) was established in January 2006 to reduce the stigma of human immunodeficiency virus (HIV) among African American faith-based organizations in South Carolina. During its first year, Project F.A.I.T.H. funded 22 churches to provide HIV-related programs and services to their congregations and surrounding communities. To determine the baseline level of HIV-related knowledge and stigmatizing attitudes, we conducted a survey with parishioners, pastors, and care team members at Project F.A.I.T.H. churches. Methods. During 2007, 20 Project F.A.I.T.H. churches conducted cross-sectional surveys with 1,445 parishioners, 61 pastors, and 109 care team members measuring their HIV-related knowledge and stigmatizing attitudes. Results. While most parishioners were very knowledgeable about HIV transmission via unprotected sex and needle sharing during injection drug use, they were less knowledgeable about transmission via casual contact, mosquitoes, donating blood, and an HIV test. Overall, HIV-related stigma was low at Project F.A.I.T.H. churches. However, males and older parishioners (aged ≥65 years) were significantly less knowledgeable and had greater HIV-related stigma than females and younger parishioners. Pastors and care team members at Project F.A.I.T.H. churches were significantly more knowledgeable and harbored significantly less stigma than their parishioners. Conclusions. To effectively address HIV-related stigma at African American churches, educational programs must reinforce the ways in which HIV can and cannot be transmitted, and pay particular attention to educating males and older populations. These findings may be helpful to HIV-prevention efforts targeting African American faith-based organizations in South Carolina and elsewhere.
Men Seeking Sex on an Intergenerational Gay Internet Website: An Exploratory Study
Authors: Sowell Richard L. , Phillips Kenneth D. 
Published: July 2017

Objective. This study explored the characteristics and sexual behaviors reported by men who have sex with men (MSM) seeking sex on an intergenerational website. Of special interest was to determine whether and how seeking sex on the Internet contributed to risky sex behaviors. Methods. This descriptive exploratory study extracted data from a stratified random sample of 1,020 profiles posted by men seeking sex on a gay intergenerational website. Frequencies and percentages were calculated for all categorical variables. Analysis of variance was used to test for differences in subgroup categories. Results. The men in the sample were primarily Caucasian (92.3%) with a mean age of 50 years (range: 18–88 years). More than one-fourth of the men (28.5%) reported being married. Of the married men, 76.0% indicated they would engage in receptive anal intercourse. Only a small number of men in the total sample expressed interest in safe sex (17.5%), while 91 men (8.9%) directly stated that they wanted unsafe sex. Most men in the sample were seeking intergenerational sexual encounters, with 71.0% of younger men expressing a preference for older men. Conclusions. The Internet can play a significant role in seeking same-sex encounters across generational groups. Safe sex was not a stated priority for most men in this study, and the Internet provides an effective method of seeking unsafe sex. A number of MSM seeking sex on the Internet were married and Caucasian. This finding suggests the need for greater attention to married and/or publicly identified Caucasian, heterosexual men in human immunodeficiency virus prevention efforts. Effective Internet-based prevention programs need to be implemented and researched.
Enrollment in Outpatient Care among Newly Released Prison Inmates with HIV Infection
Authors: Baillargeon Jacques G. , Giordano Thomas P. , Harzke Amy Jo , Baillargeon Gwen , Rich Josiah D. , Paar David P. 
Published: July 2017

Objectives. Although many prisoners infected with human immunodeficiency virus (HIV) initiate and adhere to treatment regimens while incarcerated, the benefits of in-prison therapy are frequently lost after community reentry. Little information is available on the percentage of released inmates who establish community-based HIV outpatient treatment in a timely fashion. We sought to determine the proportion of HIV-infected Texas prison inmates who enrolled in an HIV clinic within 90 days after release and to identify variables associated with timely linkage to clinical care. Methods. This was a retrospective cohort study of 1,750 HIV-infected inmates who were released from the Texas Department of Criminal Justice (TDCJ) and returned to Harris County between January 2004 and December 2007. We obtained demographic and clinical data from centralized databases maintained by TDCJ and the Harris County Health District, and used logistic regression analysis to identify factors associated with linkage to post-release outpatient care. Results. Only 20% of released inmates enrolled in an HIV clinic within 30 days of release, and only 28% did so within 90 days. Released inmates ≥30 years of age were more likely than their younger counterparts to have enrolled in care at the 30- and 90-day time points. Inmates diagnosed with schizophrenia were more likely to have initiated care within 30 days. Inmates who received antiretroviral therapy while incarcerated and those who received enhanced discharge planning were more likely to begin care at both time points. Conclusions. A large proportion of HIV-infected inmates fail to establish outpatient care after their release from the Texas prison system. Implementation of intensive discharge planning programs may be necessary to ensure continuity of HIV care among newly released inmates.
The Role, Challenges, and Support of PulseNet Laboratories in Detecting Foodborne Disease Outbreaks
Authors: Boxrud David , Monson Timothy , Stiles Tracy , Besser John 
Published: July 2017

In recent years, there have been several high-profile nationwide foodborne outbreaks due to enteric organisms in food products, including Salmonella Typhimurium in peanut products, Salmonella Saintpaul in peppers, and Escherichia coli O157:H7 in spinach. PulseNet, the national molecular subtyping network for foodborne disease surveillance, played a key role in detecting each of these outbreaks. PulseNet laboratories use bacterial subtyping methods to rapidly detect clusters of foodborne disease, which are often the first indication that an outbreak is occurring. Rapid outbreak detection reduces ongoing transmission through product recalls, restaurant closures, and other mechanisms. By greatly increasing the sensitivity of outbreak detection, PulseNet allows us to identify and correct problems with our food production and distribution systems that would not otherwise have come to our attention. Annually, millions of potentially preventable cases of foodborne illness result in billions of dollars in lost productivity and health-care expenses. We describe the critical role PulseNet laboratories play in the detection of foodborne outbreaks and discuss current challenges and potential improvements for PulseNet laboratories to more rapidly identify future foodborne outbreaks.
Southeastern Regional Pediatric Disaster Surge Network: A Public Health Partnership
Authors: Ginter Peter M. , Rucks Andrew C. , Duncan W. Jack , Wingate Martha S. , Beeman S. Kenn , Reeves Jane , West Maury A. 
Published: July 2017

In the event of a natural or man-made disaster involving large numbers of children, resources in the Southeastern U.S. are extremely limited. This article chronicles the efforts of the Alabama Department of Public Health, the Mississippi State Department of Health, and the South Central Center for Public Health Preparedness in conjunction with more than 40 organizations to develop a voluntary network of health-care providers, public health departments, volunteers, and emergency responders from Alabama, Florida, Louisiana, Mississippi, and Tennessee. The purpose of the Southeastern Regional Pediatric Disaster Surge Network (the Network) is to improve the pediatric preparedness response strategies of public health, emergency response, and pediatric providers in the event of large-scale emergencies or disasters that overwhelm local or state pediatric resources. The planning and development of the Network is proceeding through three general phases—information sharing, mutual goal setting and collective action, and long-term formal linkages. In Phase 1, critical planning tasks to be undertaken in the development of the Network were identified. In Phase 2, the agencies developed a draft operational handbook that served as the basis for a formal memorandum of understanding. In Phase 3, participants will engage in exercises and evaluations that will further identify and work out logistical and operational details.
Michigan Clostridium Difficile Hospital Discharges: Frequency, Mortality, and Charges, 2002–2008
Authors: VerLee Kerrie E. , Finks Jennie L. , Wilkins Melinda J. , Wells Eden V. 
Published: July 2017

Objective. Clostridium difficile (C. difficile) causes an intestinal bacterial infection of increasing importance in Michigan residents and health-care facilities. The specific burden and health-care costs of C. difficile infection (CDI) were previously unknown. We evaluated the frequency, mortality, and health-care charges of CDI from Michigan hospital discharge data. Methods. The Michigan Department of Community Health purchased discharge data from all Michigan acute care hospitals from the Michigan Health and Hospital Association. We extracted all hospital discharges from 2002 through 2008 containing the International Classification of Diseases, Ninth Revision code for intestinal infection due to C. difficile. Discharges were stratified by principle diagnosis and comorbidity level. Total hospitalization charges were standardized to the 2008 U.S. dollar. Results. From 2002 through 2008, 68,686 hospital discharges with CDI occurred. The annual rate increased from 463.1 to 1096.5 CDI discharges per 100,000 discharges. CDI discharge rates were substantially higher among the elderly, females, and black people. Of all CDI discharges, 5,924 (8.6%) patients died. The mean total health-care charge for the time period was $67,149, and the annual mean increased 35% from 2002 to 2008. Hospital charges varied significantly by race/ethnicity and age. People with Medicaid insurance accrued the highest charges. Conclusion. Across Michigan, the CDI burden is growing substantially and affecting vulnerable populations. Surveillance utilizing hospital discharge data can illuminate trends and inform intervention targets. To reduce disease and health-care charges, increased prevention and infection-control efforts should be directed toward high-risk populations, such as the elderly.
Using Emergency Department Data to Conduct Dog and Animal Bite Surveillance in New York City, 2003–2006
Authors: Bregman Brooke , Slavinski Sally 
Published: July 2017

Objectives. Most animal bites in the United States are due to dogs, with approximately 4.7 million reports per year. Surveillance for dog and other animal bites requires a substantial investment of time and resources, and underreporting is common. We described the use and findings of electronic hospital emergency department (ED) chief complaint data to characterize patients and summarize trends in people treated for dog and other animal bites in New York City (NYC) EDs between 2003 and 2006. Methods. Retrospective data were obtained from the syndromic surveillance system at the NYC Department of Health and Mental Hygiene. We used a statistical program to identify chief complaint free-text fields as one of four categories of animal bites. We evaluated descriptive statistics and univariate associations on the available demographic data. The findings were also compared with data collected through the existing passive reporting animal bite surveillance system. Results. During the study period, more than 6,000 animal bite patient visits were recorded per year. The proportion of visits for animal bites did not appear to change over time. Dog bites accounted for more than 70% and cat bites accounted for 13% of animal bite patient visits. Demographic characteristics of patients were similar to those identified in NYC's passive surveillance system. Conclusions. Our findings suggest that the use of ED data offers a simple, less resource-intensive, and sustainable way of conducting animal bite surveillance and a novel use of syndromic surveillance data. However, it cannot replace traditional surveillance used to manage individual patients for potential rabies exposures.
Passenger Contact Investigation Associated with a Transport Driver with Pulmonary Tuberculosis
Authors: Powell Krista , Lamb Molly M. , Sisk Mary K. , Federline Lynn , Seechuk Kimberly , Lambert Lauren A. , Buff Ann M. 
Published: July 2017

Objectives. In October 2008, pulmonary tuberculosis (TB) was diagnosed in a driver who had transported 762 passengers in the District of Columbia metropolitan area during his infectious period. A passenger contact investigation was conducted by the six public health jurisdictions because of concern that some passengers might be infected with HIV or have other medical conditions that put them at increased risk for developing TB disease if infected. Methods. Authorities evaluated 92 of 100 passengers with at least 90 minutes of cumulative exposure. Passengers with fewer than 90 minutes of cumulative exposure were evaluated if they had contacted the health department after exposure and had a medical condition that increased their risk of TB. A tuberculin skin test (TST) result of at least 5 millimeters induration was considered positive. Results. Of 153 passengers who completed TST evaluation, 11 (7%) had positive TST results. TST results were not associated with exposure time or high-risk medical conditions. No TB cases were identified in the passengers. Conclusions. The investigation yielded insufficient evidence that Mycobacterium tuberculosis transmission to passengers had occurred. TB-control programs should consider transportation-related passenger contact investigations low priority unless exposure is repetitive or single-trip exposure is long.