bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pandemic Preparedness in Hawaii: A Multicenter Verification of Real-Time RT-PCR for the Direct Detection of Influenza Virus Types A and B
Authors: Whelen A. Christian , Bankowski Matthew J. , Furuya Glenn , Honda Stacey , Ueki Robert , Chan Amelia , Higa Karen , Kumashiro Diane , Moore Nathaniel , Lee Roland , Koyamatsu Terrie , Effler Paul V. 
Published: July 2017

Objective. We integrated multicenter, real-time (RTi) reverse transcription polymerase chain reaction (RT-PCR) screening into a statewide laboratory algorithm for influenza surveillance and response. Methods. Each of three sites developed its own testing strategy and was challenged with one randomized and blinded panel of 50 specimens previously tested for respiratory viruses. Following testing, each participating laboratory reported its results to the Hawaii State Department of Health, State Laboratories Division for evaluation and possible discrepant analysis. Results. Two of three laboratories reported a 100% sensitivity and specificity, resulting in a 100% positive predictive value and a 100% negative predictive value (NPV) for influenza type A. The third laboratory showed a 71% sensitivity for influenza type A (83% NPV) with 100% specificity. All three laboratories were 100% sensitive and specific for the detection of influenza type B. Discrepant analysis indicated that the lack of sensitivity experienced by the third laboratory may have been due to the analyte-specific reagent probe used by that laboratory. Use of a newer version of the product with a secondary panel of 20 specimens resulted in a sensitivity and specificity of 100%. Conclusions. All three laboratories successfully verified their ability to conduct clinical testing for influenza using diverse nucleic acid extraction and RTi RT-PCR platforms. Successful completion of the verification by all collaborating laboratories paved the way for the integration of those facilities into a statewide laboratory algorithm for influenza surveillance and response.
The Evidence Base for Effectiveness of Preparedness Training: A Retrospective Analysis
Authors: Potter Margaret A. , Miner Kathleen R. , Barnett Daniel J. , Cadigan Rebecca , Lloyd Laura , Olson Debra K. , Parker Cindy , Savoia Elena , Shoaf Kimberley 
Published: July 2017

Objectives. In 2007, the Centers for Disease Control and Prevention (CDC) commissioned an Evidence-Based Gaps Collaboration Group to consider whether past experience could help guide future efforts to educate and train public health workers in responding to emergencies and disasters. Methods. The Group searched the peer-reviewed literature for preparedness training articles meeting three criteria: publication during the period when CDC's Centers for Public Health Preparedness were fully operational, content relevant to emergency response operations, and content particular to the emergency response roles of public health professionals. Articles underwent both quantitative and qualitative analyses. Results. The search identified 163 articles covering the topics of leadership and command structure (18.4%), information and communications (14.1%), organizational systems (78.5%), and others (23.9%). The number of reports was substantial, but their usefulness for trainers and educators was rated only “fair” to “good.” Thematic analysis of 137 articles found that organizational topics far outnumbered leadership, command structure, and communications topics. Disconnects among critical participants—including trainers, policy makers, and public health agencies—were noted. Generalizable evaluations were rare. Conclusions. Reviews of progress in preparedness training for the public health workforce should be repeated in the future. Governmental investment in training for preparedness should continue. Future training programs should be grounded in policy and practice needs, and evaluations should be based on performance improvement.
State Courts and Public Health: Building Partnerships to Enhance Preparedness
Authors: Sweeney Patricia M. , Stebbins Samuel , Stier Daniel D. , Pines Zygmont 
Published: July 2017

Laws and regulations can facilitate or impede emergency preparedness and response activities. State legislators, judges, and lawyers play critically important roles in creating and interpreting laws that affect the ability of public health practitioners and their partners to effectively respond to emergencies. In an age when political unrest, global travel, and emerging biological threats can combine to create social and economic havoc worldwide, it is critical that those responsible for upholding the rule of law during emergencies understand the law and its implications. In 2003, the University of Pittsburgh Center for Public Health Preparedness (UP-CPHP) created a Preparedness Law and Policy Program to advance legal preparedness for public health emergencies across Pennsylvania and the nation. To achieve this goal, UP-CPHP has partnered with local, state, and national organizations. In the course of these activities, Pennsylvania judges, the Administrative Office of Pennsylvania Courts, UP-CPHP, and the Centers for Disease Control and Prevention's Public Health Law Program have developed a strong and enduring collaborative relationship that has put the Pennsylvania judiciary in a better position today to plan for and respond to a public health crisis than it has been at any other point in its history. The tools and resources developed through this collaboration can readily be adapted to assist other jurisdictions nationwide in their efforts to ensure that their judicial systems are similarly prepared.
Trends in the Risk of U.S. Polio Outbreaks and Poliovirus Vaccine Availability for Response
Authors: Thompson Kimberly M. , Wallace Gregory S. , Tebbens Radboud J. Duintjer , Smith Philip J. , Barskey Albert E. , Pallansch Mark A. , Gallagher Kathleen M. , Alexander James P. , Armstrong Gregory L. , Cochi Stephen L. , Wassilak Steven G. F. 
Published: July 2017

Objectives. The United States eliminated indigenous wild polioviruses (WPVs) in 1979 and switched to inactivated poliovirus vaccine in 2000, which quickly ended all indigenous live poliovirus transmission. Continued WPV circulation and use of oral poliovirus vaccine globally allow for the possibility of reintroduction of these viruses. We evaluated the risk of a U.S. polio outbreak and explored potential vaccine needs for outbreak response. Methods. We synthesized information available on vaccine coverage, exemptor populations, and population immunity. We used an infection transmission model to explore the potential dynamics of a U.S. polio outbreak and potential vaccine needs for outbreak response, and assessed the impacts of heterogeneity in population immunity for two different subpopulations with potentially low coverage. Results. Although the risk of poliovirus introduction remains real, widespread transmission of polioviruses appears unlikely in the U.S., given high routine coverage. However, clusters of un- or underimmunized children might create pockets of susceptibility that could potentially lead to one or more paralytic polio cases. We found that the shift toward combination vaccine utilization, with limited age indications for use, and other current trends (e.g., decreasing proportion of the population with immunity induced by live polioviruses and aging of vaccine exemptor populations) might increase the vulnerability to poliovirus reintroduction at the same time that the ability to respond may decrease. Conclusions. The U.S. poliovirus vaccine stockpile remains an important resource that may potentially be needed in the future to respond to an outbreak if a live poliovirus gets imported into a subpopulation with low vaccination coverage.
Racial/Ethnic Variations in the Prevalence of Selected Major Birth Defects, Metropolitan Atlanta, 1994–2005
Authors: Kucik James E. , Alverson Clinton J. , Gilboa Suzanne M. , Correa Adolfo 
Published: July 2017

Objectives. Birth defects are the leading cause of infant mortality and are responsible for substantial child and adult morbidity. Documenting the variation in prevalence of birth defects among racial/ethnic subpopulations is critical for assessing possible variations in diagnosis, case ascertainment, or risk factors among such groups. Methods. We used data from the Metropolitan Atlanta Congenital Defects Program, a population-based birth defects registry with active case ascertainment. We estimated the racial/ethnic variation in prevalence of 46 selected major birth defects among live births, stillbirths, and pregnancy terminations at >20 weeks gestation among mothers residing in the five central counties of metropolitan Atlanta between 1994 and 2005, adjusting for infant sex, maternal age, gravidity, and socioeconomic status (SES). We also explored SES as a potential effect measure modifier. Results. Compared with births to non-Hispanic white women, births to non-Hispanic black women had a significantly higher prevalence of five birth defects and a significantly lower prevalence of 10 birth defects, while births to Hispanic women had a significantly higher prevalence of four birth defects and a significantly lower prevalence of six birth defects. The racial/ethnic disparities in the prevalence of some defects varied by SES, but no clear pattern emerged. Conclusions. Racial/ethnic disparities were suggested in 57% of included birth defects. Disparities in the prevalence of birth defects may result from different underlying genetic susceptibilities; exposure to risk factors; or variability in case diagnosis, ascertainment, or reporting among the subpopulations examined. Policies that improve early diagnosis of birth defects could reduce associated morbidity and mortality.
Resources That May Matter: The Impact of Local Health Department Expenditures on Health Status
Authors: Erwin Paul Campbell , Mays Glen P. , Riley William J. 
Published: July 2017

Objectives. This study examines the association between changes in local health department (LHD) expenditures, aggregated to the state level, and changes in state-level measures of health, from 1993 to 2005. The literature on the impact of LHD resources on health status has been limited by cross-sectional designs. With repeated surveys of LHDs, it is now possible to use longitudinal designs to explore the association between LHD inputs and outcomes. Methods. This was a retrospective cohort study. We used a fixed-effects regression model to assess the association between LHD expenditures, aggregated to the state level, and seven separate health measures. We derived LHD expenditure data from the National Association of County and City Health Officials' surveys of LHDs in 1993, 1997, and 2005. We obtained secondary data on seven health measures—smoking and obesity prevalence, infectious disease morbidity, infant mortality, deaths due to cardiovascular disease and cancer, and overall premature death—through the America's Health Rankings® reports, 1990–2008. Usable data were available for 1,470 LHDs, representing 37 states. Results. An increase in LHD expenditures, aggregated to the state level, was associated with a statistically significant decline in state-level infectious disease morbidity (t= −3.28, p=0.002) and in years of potential life lost (YPLL) (t= −2.73, p=0.008). For every $10 increase in aggregated LHD expenditures per capita, infectious disease morbidity decreased by 7.4%, and YPLL decreased by 1.5%. Conclusion. LHD resources are associated with improvements in preventable causes of morbidity and mortality.
Preventable Injury Deaths: A Population-Based Proxy of Child Maltreatment Risk in California
Authors: Putnam-Hornstein Emily 
Published: July 2017

Objective. This study used group variations in child injury fatality rates to assess racial bias in the population of children identified as victims of maltreatment. Methods. Injury fatality and maltreatment data from California were compiled for the years 1998–2007. Death and maltreatment risk ratios (RRs) and 95% confidence intervals (CIs) were computed by race and age. Rates of excess child injury mortality by race were derived from three different baseline rates of death. Substantiations per excess injury death were calculated. Results. Compared with white children, black children faced a risk of substantiated maltreatment that was more than twice as great (black RR: 2.39, 95% CI 2.37, 2.42) and were fatally injured at nearly twice the rate (black RR: 1.89, 95% CI 1.68, 2.12). Per excess death, however, black children had rates of substantiated maltreatment allegations that were equivalent to or lower than the rates for white children. Conclusions. These data support claims that, at least in California, black-white racial disparities observed in maltreatment rates reflect real group differences in risk. These data provide no evidence of systematic racial bias in the child protective services' substantiation process.
HIV Testing and Management: Findings from a National Sample of Asian/Pacific Islander Men Who Have Sex with Men
Authors: Wong Frank Y. , Nehl Eric J. , Han Jennifer J. , Huang Z. Jennifer , Wu Yu , Young Darwin , Ross Michael W. ,   The MATH Study Consortium
Published: July 2017

Objectives. We examined reasons for and barriers to participating in HIV voluntary counseling and testing for Asian/Pacific Islander (A/PI) men who have sex with men (MSM) in the U.S. Methods. We collected data between June 2007 and September 2009 in a study known as Men of Asia Testing for HIV, using a cross-sectional community-based participatory design. This national study was conducted in seven U.S. metropolitan cities through a coalition of seven community-based organizations. Results. Participants included 445 self-identified A/PI MSM aged ≥18 years. Perception of being at risk was the number one reason for testing behaviors. For first-time testers, structural barriers (e.g., language barriers with health professionals) and fear of disclosure (e.g., sexual orientation not known to parents) were deterrents for nontesting in the past. Among previously known HIV-positive men, 22% were not seeing a doctor and 19% were not taking any HIV medications. Conclusions. HIV testing, care, and treatment policies would be less than optimal without addressing barriers to testing, including stigma related to sexual orientation, among A/PI MSM.
State Health Department Perceived Utility of and Satisfaction with ArboNET, the U.S. National Arboviral Surveillance System
Authors: Lindsey Nicole P. , Brown Jennifer A. , Kightlinger Lon , Rosenberg Lauren , Fischer Marc ,   The ArboNET Evaluation Working Group
Published: July 2017

Objectives. We assessed the perceived utility of data collected through ArboNET, the national arboviral surveillance system, and evaluated state health department user satisfaction with system function. Methods. We used an online assessment tool to collect information about types of arboviral surveillance conducted, user satisfaction with ArboNET's performance, and use of data collected by the system. Representatives of all 53 reporting jurisdictions were asked to complete the assessment during spring 2009. Results. Representatives of 48 (91%) jurisdictions completed the assessment. Two-thirds of respondents were satisfied with ArboNET's overall performance. Most concerns were related to data transmission, particularly the lack of compatibility with the National Electronic Disease Surveillance System (NEDSS). Users found mosquito (85%), human disease (80%), viremic blood donor (79%), and veterinary disease (75%) surveillance data to be useful. While there was disagreement about the usefulness of avian mortality and sentinel animal surveillance, only 15% of users supported eliminating these categories. Respondents found weekly maps and tables posted on the U.S. Geological Survey (92%) and CDC (88%) websites to be the most useful reports generated from ArboNET data. Although many jurisdictions were willing to report additional clinical or laboratory data, time and resource constraints were considerations. Most respondents (71%) supported review and possible revision of the national case definition for human arboviral disease. Conclusions. As a result of this assessment, CDC and partner organizations have made ArboNET NEDSS-compatible and revised national case definitions for arboviral disease. Alternative data-sharing and reporting options are also being considered. Continued evaluation of ArboNET will help ensure that it continues to be a useful tool for national arboviral disease surveillance.
A Comparison of Two Surveillance Strategies for Selected Birth Defects in Florida
Authors: Salemi Jason L. , Tanner Jean Paul , Kennedy Sara , Block Suzanne , Bailey Marie , Correia Jane A. , Watkins Sharon M. , Kirby Russell S. 
Published: July 2017

Objective. We linked data from two independent birth defects surveillance systems with different case-finding methods in an overlapping geographic area to assess Florida's suveillance of birth defects (e.g., neural tube defects, orofacial clefts, gastroschisis/omphalocele, and chromosomal defects), focusing on sensitivity and completeness of ascertainment measures. Methods. Live-born infants identified from each system born during 2003–2006 in a nine-county catchment area with specific birth defects were linked to birth certificates. Using the enhanced surveillance system as a gold standard, we calculated the sensitivity of the Florida Birth Defects Registry (FBDR) for identifying infants. Next, we used capture-recapture models to estimate the completeness of case ascertainment and the prevalence of each birth defect in the catchment area. We used multivariable logistic regression models with backward elimination to estimate adjusted odds ratios and 95% confidence intervals for factors significantly associated with the FBDR's failure to capture infants ultimately identified by enhanced surveillance. Results. The FBDR's sensitivity was 89.3%, and the overall completeness of ascertainment was estimated as 86.6%. Defect-specific sensitivity and completeness of ascertainment varied significantly by defect. The combined defect-specific sensitivity for all malformations under study was 86.6%; completeness of ascertainment ranged from 45.6% for anencephaly to 88.6% for Down syndrome, 87.9% for spina bifida without anencephaly, and 87.0% for orofacial clefts. Conclusions. For the defects under study, the FBDR captured nearly nine of every 10 infants born with selected birth defects. However, the FBDR's ability to identify specific defects was both more limited and defect dependent with widely varying defect-specific sensitivities.
Understanding Oral Health Promotion Needs and Opportunities of Tobacco Quitline Callers
Authors: McClure Jennifer B. , Riggs Karin R. , St. John Jackie , Cerutti Barbara , Zbikowski Susan 
Published: July 2017

Objective. Improving oral health and oral health care are important public health goals. Tobacco users and smokers are at particularly high risk for oral disease and warrant targeted intervention efforts. We assessed the need for and acceptability of targeting tobacco quitline callers for an oral health promotion intervention. Methods. We surveyed 816 Washington State Quitline callers to assess their oral health, relevant self-care behaviors, and interest in oral health promotion intervention. Results. Most respondents were female, cigarette smokers, of low socioeconomic status, with no dental insurance. Of the respondents, 79.3% ( n=647) had some or all of their natural teeth (e.g., dentate); however, most of these respondents failed to meet recommendations for daily oral hygiene (brushing and flossing) (83.9%, n=543) and had no dental visits in the past year (52.6%, n=340). Similar findings were observed among respondents with no insurance. Many respondents were interested in learning more about how to improve their oral health (57.4%, n=468), willing to speak with a quitline coach about improving their oral health (48.2%, n=393), and open to receiving additional oral health information by mail (62.7%, n=512) or the Internet (50.0%, n=408). People who were receptive to learning how to improve their oral health were significantly more likely to be nonwhite, have a low income, have no dental insurance, and not have visited a dentist in the past year. Conclusion. There is a need and an opportunity to target quitline callers for oral health promotion services, as those most in need of these services were open to receiving them.
Prevalence, Distribution, and Correlates of Hepatitis C Virus Infection among Homeless Adults in Los Angeles
Authors: Gelberg Lillian , Robertson Marjorie J. , Arangua Lisa , Leake Barbara D. , Sumner Gerald , Moe Ardis , Andersen Ronald M. , Morgenstern Hal , Nyamathi Adeline 
Published: July 2017

Objective. We documented the prevalence, distribution, and correlates of hepatitis C virus (HCV) infection among urban homeless adults. Methods. We sampled a community-based probability sample of 534 homeless adults from 41 shelters and meal programs in the Skid Row area of downtown Los Angeles, California. Participants were interviewed and tested for HCV, hepatitis B, and HIV. Outcomes included prevalence, distribution, and correlates of HCV infection; awareness of HCV positivity; and HCV counseling and treatment history. Results. Overall, 26.7% of the sample tested HCV-positive and 4.0% tested HIV-positive. In logistic regression analysis, independent predictors of HCV infection for the total sample included older age, less education, prison history, and single- and multiple-drug injection. Among lifetime drug injectors, independent predictors of HCV infection included older age, prison history, and no history of intranasal cocaine use. Among reported non-injectors, predictors of HCV infection included older age, less education, use of non-injection drugs, and three or more tattoos. Sexual behaviors and snorting or smoking drugs had no independent relationship with HCV infection. Among HCV-infected adults, nearly half (46.1%) were unaware of their infection. Conclusions. Despite the high prevalence of HCV infection, nearly half of the cases were hidden and few had ever received any HCV-related treatment. While injection drug use was the strongest independent predictor, patterns of injection drug use, non-injection drug use, prison stays, and multiple tattoos were also independent predictors of HCV. Findings suggest that urgent interventions are needed to screen, counsel, and treat urban homeless adults for HCV infection.