bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association between Neighborhood Poverty and HIV Diagnoses among Males and Females in New York City, 2010–2011
Authors: Wiewel Ellen W. , Bocour Angelica , Kersanske Laura S. , Bodach Sara D. , Xia Qiang , Braunstein Sarah L. 
Published: June 2016

Objective. We assessed the association of neighborhood poverty with HIV diagnosis rates for males and females in New York City. Methods. We calculated annual HIV diagnosis rates by ZIP Code, sex, and neighborhood poverty level using 2010–2011 New York City (NYC) HIV surveillance data and data from the U.S. Census 2010 and American Community Survey 2007–2011. Neighborhood poverty levels were percentage of residents in a ZIP Code with incomes below the federal poverty threshold, categorized as 0%–<10% (low poverty), 10%–<20% (medium poverty), 20%–<30% (high poverty), and 30%–100% (very high poverty). We used sex-stratified negative binomial regression models to measure the association between neighborhood-level poverty and HIV diagnosis rates, controlling for neighborhood-level education, race/ethnicity, age, and percentage of men who have sex with men. Results. In 2010–2011, 6,184 people were newly diagnosed with HIV. Median diagnosis rates per 100,000 population increased by neighborhood poverty level overall (13.7, 34.3, 50.6, and 75.6 for low-, medium-, high-, and very high-poverty ZIP Codes, respectively), for males, and for females. In regression models, higher neighborhood poverty remained associated with higher diagnosis rates among males (adjusted rate ratio [ARR] = 1.63, 95% confidence interval [CI] 1.34, 1.97) and females (ARR=2.14, 95% CI 1.46, 3.14) for very high- vs. low-poverty ZIP Codes. Conclusion. Living in very high- vs. low-poverty urban neighborhoods was associated with increased HIV diagnosis rates. After controlling for other factors, the association between poverty and diagnosis rates was stronger among females than among males. Alleviating poverty may help decrease HIV-related disparities.
Mycobacterium Tuberculosis Infection, Immigration Status, and Diagnostic Discordance: A Comparison of Tuberculin Skin Test and QuantiFERON®-TB Gold in-Tube Test among Immigrants to the U.S.
Authors: Wilson Fernando A. , Miller Thaddeus L. , Stimpson Jim P. 
Published: June 2016

Objective. We used a recent source of nationally representative population data on tuberculosis (TB) infection to characterize concordance between the tuberculin skin test (TST) and the QuantiFERON®-TB Gold In-Tube (QFT-GIT) blood test for immigrants in the United States. Methods. We used TB screening data from the 2011–2012 National Health and Nutrition Examination Survey to examine concordance between the TST and QFT-GIT—an interferon-gamma release assay (IGRA) blood test—for 7,097 U.S. natives, naturalized citizens, and noncitizens. Results. Consistent with prior findings, one in five immigrants in the survey was identified with latent TB infection (LTBI), a rate 14 times higher than for U.S. natives. We also found higher rates of discordant TST/IGRA results among immigrants than among U.S. natives. Unadjusted discordance between TST and IGRA was 3% among U.S. natives (weighted N=5,684,274 of 191,179,213) but ranged up to 19% for noncitizens (weighted N=3,722,960 of 19,377,147). Adjusting for age, sex, and race/ethnicity, noncitizens had more than nine times the odds of having a positive TST result but negative QFT-GIT result compared with U.S. natives. Conclusions. Our findings suggest that whether and how either of these tests should be deployed is highly context sensitive. Significant discordance in test results when used among immigrants raises the possibility of missed opportunities for harm reduction in this already at-risk population. However, we found little distinction between the tests in terms of diagnostic outcome when used in a U.S. native population, suggesting little benefit to the adoption and use of the QFT-GIT test in place of TST on the basis of test performance alone for this population.
HIV Testing among Men at Risk for Acquiring HIV Infection before and after the 2006 CDC Recommendations
Authors: Kwan Candice K. , Rose Charles E. , Brooks John T. , Marks Gary , Sionean Catlainn 
Published: June 2016

Objectives. Testing for human immunodeficiency virus (HIV) is the key first step in HIV treatment and prevention. In 2006, the Centers for Disease Control and Prevention (CDC) recommended annual HIV testing for people at high risk for HIV infection. We evaluated HIV testing among men with high-risk heterosexual (HRH) contact and sexually active men who have sex with men (MSM) before and after the CDC recommendations. Methods. We used data from the National Survey of Family Growth, 2002 and 2006–2010, to assess proportions of HRH respondents and MSM reporting HIV testing in the prior 12 months, compare rates of testing before and after release of the 2006 CDC HIV testing guidelines, and examine demographic variables and receipt of health-care services as correlates of HIV testing. Results. Among MSM, the proportion tested was 37.2% (95% confidence interval [CI] 28.2, 47.2) in 2002, 38.2% (95% CI 25.9, 52.2) in 2006–2008, and 41.7% (95% CI 29.2, 55.3) in 2008–2010; among HRH respondents, the proportion was 23.7% (95% CI 20.5, 27.3) in 2002, 24.5% (95% CI 20.9, 28.7) in 2006–2008, and 23.9% (95% CI 20.2, 28.1) in 2008–2010. HIV testing was more likely among MSM and HRH respondents who received testing or treatment for sexually transmitted disease in the prior 12 months, received a physical examination in the prior 12 months (MSM only), or were incarcerated in the prior 12 months. Conclusions. The rate of annual HIV testing was low for men with sexual risk for HIV infection, and little improvement took place from 2002 to 2006–2010. Interventions aimed at men at risk, especially MSM, in both nonmedical and health-care settings, likely could increase HIV testing.
The Great Recession of 2007–2009 and Public Insurance Coverage for Children in Alabama: Enrollment and Claims Data from 1999–2011
Authors: Morrisey Michael A. , Blackburn Justin , Becker David J. , Sen Bisakha , Kilgore Meredith L. , Caldwell Cathy , Menachemi Nir 
Published: June 2016

Objectives. This study examined the impact of the Great Recession of 2007–2009 on public health insurance enrollment and expenditures in Alabama. Our analysis was designed to provide a framework for other states to conduct similar analyses to better understand the relationship between macroeconomic conditions and public health insurance costs. Methods. We analyzed enrollment and claims data from Medicaid and the Children's Health Insurance Program (CHIP) in Alabama from 1999 through 2011. We examined the relationship between county-level unemployment rates and enrollment in Medicaid and CHIP, as well as total county-level expenditures in the two programs. We used linear regressions with county fixed effects to estimate the impact of unemployment changes on enrollment and expenditures after controlling for population and programmatic changes in eligibility and cost sharing. Results. A one-percentage-point increase in a county's unemployment rate was associated with a 4.3% increase in Medicaid enrollment, a 0.9% increase in CHIP enrollment, and an overall increase in public health insurance enrollment of 3.7%. Each percentage-point increase in unemployment was associated with a 6.2% increase in total public health insurance expenditures on children, with Medicaid spending rising by 7.5% and CHIP spending rising by 1.8%. In response to the 6.4 percentage-point increase in the state's unemployment rate during the Great Recession, combined enrollment of children in Alabama's public health insurance programs increased by 24% and total expenditures rose by 40%. Conclusion. Recessions have a substantial impact on the number of children enrolled in CHIP and Medicaid, and a disproportionate impact on program spending. Programs should be aware of the likely magnitudes of the effects in their budget planning.
Dependency on Smartphone Use and its Association with Anxiety in Korea
Authors: Lee Kyung Eun , Kim Si-Heon , Ha Tae-Yang , Yoo Young-Myong , Han Jai-Jun , Jung Jae-Hyuk , Jang Jae-Yeon 
Published: June 2016

Objective. South Korea has the highest rate of smartphone ownership worldwide, which is a potential concern given that smartphone dependency may have deleterious effects on health. We investigated the relationship between smartphone dependency and anxiety. Methods. Participants included 1,236 smartphone-using students (725 men and 511 women) from six universities in Suwon, South Korea. Participants completed measures of smartphone use, smartphone dependency, anxiety, and general characteristics (i.e., demographic, health-related, and socioeconomic characteristics). To measure smartphone dependency and anxiety, we used questionnaires of Yang's test developed from Young's Internet Addiction Test and Zung's Self-Rating Anxiety Scale. We used multiple logistic regression to determine the association between smartphone dependency and anxiety after adjusting for relevant factors. Results. On a scale from 25 to 100, with higher scores on the smartphone dependency test indicating greater dependency, women were significantly more dependent on smartphones than were men (mean smartphone dependency score: 50.7 vs. 56.0 for men and women, respectively, p<0.001). However, the amount of time spent using smartphones and the purpose of smartphone use affected smartphone dependency in both men and women. Particularly, when daily use time increased, smartphone dependency showed an increasing trend. Compared with times of use <2 hours vs. ≥6 hours, men scored 46.2 and 56.0 on the smartphone dependency test, while women scored 48.0 and 60.4, respectively ( p<0.001). Finally, for both men and women, increases in smartphone dependency were associated with increased anxiety scores. With each one-point increase in smartphone dependency score, the risk of abnormal anxiety in men and women increased by 10.1% and 9.2%, respectively ( p<0.001). Conclusion. Among this group of university students in South Korea, smartphone dependency appeared to be associated with increased anxiety. Standards for smartphone use might help prevent deleterious health effects.
A Review of State Licensing Regulations to Determine Alignment with Best Practices to Prevent Human Norovirus Infections in Child-Care Centers
Authors: Leone Cortney M. , Jaykus Lee-Ann , Cates Sheryl M. , Fraser Angela M. 
Published: June 2016

Objectives. Close, frequent contact between children and care providers in child-care centers presents many opportunities to spread human noroviruses. We compared state licensing regulations for child-care centers with national guidelines written to prevent human noroviruses. Methods. We reviewed child-care licensing regulations for all 50 U.S. states and the District of Columbia in effect in June 2015 to determine if these regulations fully, partially, or did not address 14 prevention practices in four topic areas: ( 1) hand hygiene, ( 2) exclusion of ill people, ( 3) environmental sanitation, and ( 4) diapering. Results. Approximately two-thirds (8.9) of the 14 practices across all state regulations were partially or fully addressed, with few (2.6) fully addressed. Practices related to exclusion of ill people and diapering were fully addressed most often, while practices related to hand hygiene and environmental sanitation were fully addressed least often. Conclusion. Regulations based on guidelines for best practices are one way to prevent the spread of human noroviruses in child-care facilities, if the regulations are enforced. Our findings show that, in mid-2015, many state child-care regulations did not fully address these guidelines, suggesting the need to review these regulations to be sure they are based on best practices
Human Papillomavirus Vaccination in Washington State: Estimated Coverage and Missed Opportunities, 2006–2013
Authors: Oltean Hanna N. , Lofy Kathryn H. , Goldoft Marcia J. , DeBolt Charla A. 
Published: June 2016

Objective. Human papillomavirus (HPV) causes almost all cervical cancer in women and contributes to vaginal, anal, oropharyngeal, and penile cancer morbidity and mortality. Although vaccines effective in preventing up to nine types of HPV are available, vaccination rates are low nationally. We assessed HPV vaccination coverage by age, sex, and county using Washington State Immunization Information System data. Methods. We calculated on-time dose coverage by county and statewide among adolescents aged 11–12 years and assessed coverage by age 18 years. We calculated missed opportunities as the number of visits at which doses of other adolescent vaccines were administered without administration of the first dose of HPV vaccine (HPV1). Results. In 2013, HPV vaccination coverage estimates with one, two, and three doses (HPV1-3) for adolescents aged 11–12 years were 48.5%, 32.4%, and 18.3% among girls and 31.2%, 17.1%, and 8.1% among boys. The three-dose HPV vaccine coverage estimate increased to 40.1% among girls by age 18 but was unchanged for boys. Coverage estimates varied by age, sex, and county. One-third of eligible unvaccinated girls and two of five eligible boys aged 11–17 years had at least one missed opportunity to receive HPV1. Conclusion. Despite a recommendation to vaccinate adolescents aged 11–12 years, HPV vaccination is often delayed and coverage levels among all age groups are below national target levels. Improved understanding of the variability of HPV vaccination coverage rates by age, sex, and county can inform targeted interventions statewide.
Utility of Keywords from Chest Radiograph Reports for Pneumonia Surveillance among Hospitalized Patients with Influenza: The CDC Influenza Hospitalization Surveillance Network, 2008–2009
Authors: Bramley Anna M. , Chaves Sandra S. , Dawood Fatimah S. , Doshi Saumil , Reingold Arthur , Miller Lisa , Yousey-Hindes Kimberly , Farley Monica M. , Ryan Patricia , Lynfield Ruth , Baumbach Joan , Zansky Shelley , Bennett Nancy , Thomas Ann , Schaffner William , Finelli Lyn , Jain Seema 
Published: June 2016

Objective. Transcripts from admission chest radiographs could aid in identification of pneumonia cases for public health surveillance. We assessed the reliability of radiographic data abstraction and performance of radiographic key terms to identify pneumonia in patients hospitalized with laboratory-confirmed influenza virus infection. Methods. We used data on patients hospitalized with laboratory-confirmed influenza virus infection from October 2008 through December 2009 from 10 geographically diverse U.S. study sites participating in the Influenza Hospitalization Surveillance Network (FluSurv-NET). Radiographic key terms (i.e., bronchopneumonia, consolidation, infiltrate, airspace density, and pleural effusion) were abstracted from final impressions of chest radiograph reports. We assessed the reliability of radiographic data abstraction by examining the percent agreement and Cohen's κ statistic between clinicians and surveillance staff members. Using a composite reference standard for presence or absence of pneumonia based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes and discharge summary data, we calculated sensitivity, specificity, positive predictive value (PPV), and percent agreement for individual and combined radiographic key terms. Results. For each radiographic key term, the percent agreement between clinicians and surveillance staff members ranged from 89.4% to 98.6% and Cohen's κ ranged from 0.46 (moderate) to 0.84 (almost perfect). The combination of bronchopneumonia or consolidation or infiltrate or airspace density terms had sensitivity of 66.5%, specificity of 89.2%, PPV of 80.4%, and percent agreement of 80.1%. Adding pleural effusion did not result in significant changes in sensitivity, specificity, PPV, or percent agreement. Conclusion. Radiographic key terms abstracted by surveillance staff members from final impressions of chest radiograph reports had moderate to almost perfect reliability and could be used to identify pneumonia among patients hospitalized with laboratory-confirmed influenza virus infection. This method can inform pneumonia surveillance and aid in public health response.
Early Identification and Linkage to Care for People with Chronic HBV and HCV Infection: The HepTLC Initiative
Authors: Ramirez Gilberto , Cabral Rebecca , Patterson Margaret , Schoenbachler Ben T. , Bedell Deborah , Smith Bryce D. , Vellozzi Claudia , Beckett Geoff A. 
Published: June 2016

Objective. In 2012, CDC's Division of Viral Hepatitis launched a public health initiative to increase hepatitis B virus (HBV) and hepatitis C virus (HCV) infection testing for those at risk and to improve linkage to medical care for those infected. We describe testing outcomes of previously unidentified people at risk for HBV and HCV infection and the lessons learned while linking patients to care. Methods. CDC's Hepatitis Testing and Linkage to Care (HepTLC) initiative provided 34 financial awards to U.S. organizations that serve people at risk for viral hepatitis, 25 of which focused on HCV and nine of which focused on HBV. Grantees offered testing and test result notification to people at risk for HBV and/or HCV infection, as well as counseling, referral, and verification or notification of linkage to care for people with positive test results. We entered demographic data, self-reported risk factors, country of origin (for HBV), and testing outcomes into a confidential database. Results. The 34 grantees tested 87,860 people at more than 260 sites in 17 states. Of the 23,144 people tested for HBV, 1,317 (6%) were positive. Of the 64,716 people tested for HCV, 57,570 (89%) received an HCV antibody (anti-HCV) test, of whom 7,580 (13%) tested anti-HCV positive. Of the 4,765 people who received an HCV RNA test, 3,449 (72%) tested positive. Of the 4,766 people who tested positive for either HBV or HCV infection, 2,116 (44%) were linked to care. Conclusion. Interventions targeting people at risk for HBV and HCV infection reached a substantial number of people for whom testing is recommended and identified a large proportion of those who had previously unrecognized infection. Patient navigation was critical for follow-up and linkage to care.
Efforts at the Frontlines: Implementing a Hepatitis C Testing and Linkage-to-Care Program at the Local Public Health Level
Authors: Seña Arlene C. , Willis Sarah J. , Hilton Alison , Anderson Alexandria , Wohl David A. , Hurt Christopher B. , Muir Andrew J. 
Published: June 2016

Objectives. The national Viral Hepatitis Action Plan recommends strengthening partnerships among health departments, community-based organizations, and health-care providers for hepatitis services. We implemented a hepatitis C virus (HCV) testing and linkage-to-care program through a local health department using similar strategies reported for HIV care. Methods. The Durham County Department of Public Health received federal funding to conduct HCV testing and linkage to care in Durham, North Carolina. HCV antibody testing with reflex RNA was offered through a sexually transmitted disease clinic, a county jail, community testing sites (including a residential substance abuse recovery program), and a homeless clinic. People with evidence of HCV infection were linked to care through an HCV bridge counselor who provided education, incentives, and transportation, and scheduled appointments with HCV specialists at nearby academic centers and on-site clinics. Results. From December 2012 through February 2014, we conducted 2,004 HCV tests, of which 326 (16.3%) were HCV antibody positive and 241 (12.0%) had detectable HCV RNA. Among the 241 people with HCV infection, 178 (73.9%) were men, and 133 (55.2%) were born between 1945 and 1965. Of 241 people with chronic HCV infection, 150 (62.2%) reported ever injecting drugs, eight (2.5%) were coinfected with HIV, and 123 (51.0%) were linked to care. Conclusion. At the local public health level, HCV testing and linkage to care can be facilitated with additional funding and by leveraging existing programs and provider networks to deliver a coordinated system of care.
Hospital-Based Hepatitis C Screening of Baby Boomers in a Majority Hispanic South Texas Cohort: Successes and Barriers to Implementation
Authors: Taylor Barbara S. , Hanson Joshua T. , Veerapaneni Poornachand , Villarreal Roberto , Fiebelkorn Kristin , Turner Barbara J. 
Published: June 2016

Objective. To comply with the 2012 CDC recommendations for hepatitis C virus (HCV) screening, we implemented a new HCV screening program for patients born between 1945 and 1965 at a South Texas safety-net hospital. Methods. Patients with no HCV diagnosis or prior HCV test received an automated order for HCV antibody (anti-HCV) tests combined with reflex HCV ribonucleic acid (RNA) polymerase chain reaction. An inpatient counselor educated anti-HCV-positive patients. A bilingual patient navigator assisted newly diagnosed chronic HCV patients with linkage to primary and specialty care. We examined results for Hispanic vs. non-Hispanic patients in the first 10 months of project implementation in 2013–2014. Results. Of 2,327 patients screened for HCV, the 192 (8%) patients who tested anti-HCV positive were younger than those who tested negative (56 vs. 58 years, respectively, p<0.001) and more likely to be male ( p<0.001). Of the 167 anti-HCV-positive patients tested for HCV RNA, 108 (65%) were HCV RNA positive (5% of cohort). Barriers to care for HCV RNA-positive patients included a lack of health insurance, current substance abuse, incarceration, and homelessness. Hispanic HCV RNA-positive patients were more likely than non-Hispanic HCV RNA-positive patients to be substance abusers or incarcerated. Of all HCV RNA-positive patients, 103 patients (95%) received counseling, 94 patients (87%) were linked to primary care, 47 patients (44%) were linked to specialty care, and eight patients (7%) started treatment. Conclusion. The prevalence of anti-HCV-positive and chronically HCV-infected patients was higher than many Hispanic or non-Hispanic white cohorts. Most Hispanic patients newly diagnosed with chronic HCV had barriers to care for HCV infection that must be overcome if HCV screening is to reduce morbidity and mortality in this population.
Early Identification and Linkage to Care of Foreign-Born People with Chronic Hepatitis B Virus Infection, Multnomah County, Oregon, 2012–2014
Authors: Walters Jaime , Sullivan Amy 
Published: June 2016

Objective. Hepatitis B virus (HBV) infection is a global health concern, with a large proportion of high-risk individuals unaware of their infection status. People born in countries with medium to high endemicity of HBV should be tested and linked to care. We describe a program that improved identification and linkage to care for refugees and immigrants at the Multnomah County Health Department in Oregon. Methods. We instituted outreach clinics and community referrals and expanded refugee screening to identify foreign-born people at risk for HBV. We obtained data from electronic health records and electronic laboratory reporting, including patient demographics, hepatitis B testing variables, vaccination history, and—for positive cases—risk-factor and linkage-to-care data. All results were entered into an Internet-based data collection tool. For this analysis, we only used results for testing performed from October 2012 through June 2014. Results. We screened 2,087 foreign-born people for HBV infection and identified 77 (4%) people with positive results. HBV infection prevalence varied by site, with 7% of HBV-positive people identified through the outreach and voucher program and 3% identified through refugee screening. Of the 77 people testing positive for HBV, 72 (94%) were successfully linked to care, of whom 68 (94%) attended their first follow-up visit. Conclusion. Implementation of a culturally competent screening program among immigrants and refugees in Multnomah County improved case finding and subsequent linkage to care.