Search

Using data from the Fragile Families and Child Wellbeing Study, this study examined the issue of American Indian nonresident father rights and obligations. Findings revealed that both American Indian mothers and fathers supported visitation rights, but decision-making rights were not highly supported unless the father was paying child support. Both American Indian parents were similar in their views regarding paternal responsibilities. Therefore, while general father involvement intervention strategies may work for American Indians, it is important for practitioners to explore how American Indians define paternal involvement and to what extent they are willing to allow the nonresident father to participate in all aspects of the child's life. [ABSTRACT FROM AUTHOR]

Fish assemblage structure, rarefied species richness, species diversity and evenness of assemblages upstream of a reservoir in Oklahoma, U.S.A., were compared pre and post-impoundment as well as in contemporary collections from streams above and below the reservoir. There were significant shifts in assemblage structure between historical and contemporary collections above the reservoir but not between contemporary assemblages above and below the impoundment. Indicator species analysis revealed that the sand shiner Notropis stramineus and fathead minnow Pimephales promelas have declined, whereas largemouth bass Micropterus salmoides and western mosquitofish Gambusia affinis have increased in relative abundance in assemblages upstream of the impoundment. Species richness was lower in contemporary assemblages compared with historical assemblages. Furthermore, contemporary assemblages below the dam had lower species richness, diversity and evenness compared with contemporary collections above the dam. These results highlight the spatial and temporal extent of reservoirs altering fish assemblages upstream of impoundments. [ABSTRACT FROM AUTHOR]

BACKGROUND: At most blood centers in the United States routine testing of donations for Trypanosoma cruzi using an enzyme-linked immunosorbent assay (ELISA) is followed by supplemental testing by radioimmunoprecipitation assay (RIPA). The objective of this study was to report the results of routine testing and risk factor data from allogeneic blood donors. STUDY DESIGN AND METHODS: T. cruzi testing data from January 2007 through December 2009 were analyzed, and risk factor interviews and follow-up studies were conducted on seroreactive donors. Prevalences of confirmed infection and risk factors associated with infection were assessed using logistic and multivariable logistic regression. RESULTS: Of 2,940,491 allogeneic donations from 1,183,076 donors, 305 (0.01% per donation tested and 0.026% per blood donor) were repeat reactive (RR) and 89 of those were confirmed positive by RIPA, yielding an overall seroprevalence of 1 per 33,039 donations and 1 per 13,292 donors. Country of birth and US blood center location differences in the seroprevalence of T. cruzi were evident. The odds of confirmed infection were highest if the donor reported having been bitten by the reduviid (kissing) bug (odds ratio [OR], 76.1; 95% confidence interval [CI], 11.1-3173) followed by having lived in a rural area of Latin America (OR, 38.6; 95% CI, 15.1-102.5). In multivariable analyses, having spent 3 months or more in Mexico or Central and/or South America was associated with the highest odds of RIPA-confirmed infection (OR, 8.5; 95% CI, 2.7-26.5). Polymerase chain reaction (PCR) testing of ELISA RR donors exhibited low sensitivity (1/22 [4%] RIPA-confirmed donors was PCR positive). CONCLUSION: Risk factors for confirmed infection in US blood donors are consistent with the known epidemiology of Chagas disease. Blood donors or transfusions do not substantially contribute to the burden of T. cruzi infection in the United States. [ABSTRACT FROM AUTHOR]

Objective: We examined relations between neighborhood context, home and family management practices, deviant peer affiliations, beliefs favorable to use, and alcohol use among urban African American and Hispanic adolescents. Method: The sample comprised 4,027 African American and Hispanic adolescents who were 50% boys and 75% low income. Participants completed surveys in 2002-2005 and 2008-2009. Structural equation modeling assessed direct and indirect relations between neighborhood context in 6th grade, home and family management practices in 7th grade, deviant peer affiliations and beliefs favorable to use in 8th grade, and alcohol use in 12th grade. Results: There was significant variation in structural models across race/ethnicity but not gender. Differences included the influence of neighborhood and school strength and, where similarities existed, differences in effect magnitude. Similarities included significant correlations among measurement components; the indirect influence of alcohol advertisement exposure, gender, area deprivation, and home alcohol access on alcohol use; direct influence of deviant peer affiliations and beliefs favorable to use on alcohol use; and indirect effects highlighting the importance of preventing home alcohol access, deviant peer affiliations, and beliefs favorable to use and promoting protective family management practices. Conclusions: Neighborhood and school strength may be particularly important in preventing alcohol use among African Americans, whereas preventing early onset of alcohol use among Hispanics remains important. Preventive efforts may wish to focus on neighborhood deprivation, exposure to alcohol advertisements, and home risks and protective factors because they have direct and indirect effects on intrapersonal factors and alcohol use. [ABSTRACT FROM AUTHOR]

Background: West Nile virus (WNV) infection is asymptomatic in most individuals, with a minority developing symptoms ranging from WNV fever to serious neuroinvasive disease. This study investigated the impact of host HLA on the outcome of WNV disease. Methods: A cohort of 210 non-Hispanic mostly white WNV+ subjects from Canada and the U.S. were typed for HLA-A, B, C, DP, DQ, and DR. The study subjects were divided into three WNV infection outcome groups: asymptomatic (AS), symptomatic (S), and neuroinvasive disease (ND). Allele frequency distribution was compared pair-wise between the AS, S, and ND groups using χ2 and Fisher's exact tests and P values were corrected for multiple comparisons (PC). Allele frequencies were compared between the groups and the North American population (NA) used as a control group. Logistic regression analysis was used to evaluate the potential synergistic effect of age and HLA allele phenotype on disease outcome. Results: The alleles HLA-A*68, C*08 and DQB*05 were more frequently associated with severe outcomes (ND VS. AS, PA*68 = 0.013/PC = 0.26, PC*08 = 0.0075/PC = 0.064, and PDQB1*05 = 0.029/PC = 0.68), However the apparent DQB1*05 association was driven by age. The alleles HLA-B*40 and C*03 were more frequently associated with asymptomatic outcome (AS vs. S, PB*40= 0.021/PC = 0.58 and AS VS. ND PC*03 = 0.039/PC = 0.64) and their frequencies were lower within WNV+ subjects with neuroinvasive disease than within the North American population (NA VS. S, PB*40 = 0.029 and NA VS. ND, PC*08 = 0.032). Conclusions: Host HLA may be associated with the outcome of WNV disease; HLA-A*68 and C*08 might function as "susceptible" alleles, whereas HLA-B*40 and C*03 might function as "protective" alleles. [ABSTRACT FROM AUTHOR]

Current US military clinical practice guidelines permit emergency transfusions of non-Food and Drug Administration (FDA)-compliant freshly collected blood products in theaters of war. This investigation aimed to characterize the risks of transfusion-transmitted infections (TTIs) associated with battlefield transfusions of non-FDA-compliant blood products. US Service members who received emergency transfusion products in Iraq and Afghanistan (March 1, 2002-September 30, 2007) were tested for hepatitis C virus (HCV), human immunodeficiency virus (HIV), and hepatitis B virus (HBV) infections using reposed pre- and posttransfusion sera. Selected regions of viral genomes from epidemiologically linked infected recipients and their donors were sequenced and compared. Of 761 US Service members who received emergency transfusion products, 475 were tested for HCV, 472 for HIV, and 469 for HBV. One transfusion-transmitted HCV infection (incidence rate of 2.1/1000 persons) was identified. The pretransfusion numbers (prevalence per 1000 persons) were HCV-four (8/1000), HIV-zero (0/1000), chronic HBV-two (4 /1000), and naturally immune (antibody to HBV core antigen)-nine (19/1000). One HCV TTI was determined to be associated with emergency blood product use. The pretransfusion HCV and HBV prevalence in transfusion recipients, themselves members of the potential donor population, indicates better characterization of the deployed force's actual donor population, and further investigations of the TTI prevalence in these donors are needed. These data will inform countermeasure development and clinical decision making. [ABSTRACT FROM AUTHOR]

Background: Babesiosis is a zoonotic disease transmitted by the Ixodes tick species. Infection often results in subclinical manifestations; however, patients with this disease can become critically ill. Splenic rupture has been a previously reported complication of babesiosis, but treatment has always led to splenectomy. Asplenia places a patient at greater risk for overwhelming post-splenectomy infection from encapsulated bacteria, Lyme disease, Ehrlichia as well as Babesia microti. Therefore, avoiding splenectomy in these patients must be considered by the physician; particularly, if the patient is at risk for re-infection by living in an endemic area. Case Presentation: A 54 year-old male from the northeast United States presented with left upper quadrant abdominal pain associated with fever, chills, night sweats and nausea. A full evaluation revealed active infection with Babesia microti and multiple splenic lacerations. This patient was successfully treated with appropriate pharmacological therapy and non-operative observation for the splenic injury. Conclusion: Patients diagnosed with Babesia microti infection are becoming more common, especially in endemic areas. Although clinical manifestations are usually minimal, this infection can present with significant injuries leading to critical illness. We present the successful non-operative treatment of a patient with splenic rupture due to babesiosis infection. [ABSTRACT FROM AUTHOR]

Background. Hepatitis E virus (HEV) has been recognized as a threat to military forces since its discovery. Although HEV seroprevalence in Afghanistan is not known, HEV infection is thought to be highly endemic in that country. This study determined the incidence of HEV seroconversion among United States (US) service members who were deployed to Afghanistan, as well as the prevalence of antibodies to HEV prior to the deployment. Methods. A random sample of 1500 subjects was selected from the cohort of service members who were deployed to Afghanistan between 2002 and 2006. Predeployment and postdeployment serum samples from these subjects were tested by enzyme immunoassay for total antibodies to HEV. Results. The seroprevalence of antibodies to HEV in US service members prior to deployment was 1.1%. The seroconversion rate among service members deployed to Afghanistan was 0.13%. Conclusions. Although subpopulations may be at higher risk for HEV exposure during deployment, the risk among US service members deployed to Afghanistan in this study was low. Previously implemented and current preventive measures in theater appear to have been adequate. With future deployments to new areas or changes in military operations in areas of risk, continued surveillance for HEV infection in the military will be warranted. [ABSTRACT FROM AUTHOR]

Background: The risk of active TB resulting from military deployment to endemic areas is unknown. It has typically been assumed that the risk of TB approximates the risk among local nationals in that country. Purpose: This nested case–control study assesses the putative association of overseas deployment with active tuberculosis among active-component U.S. military service members. Methods: Deployment histories and other exposures among 578 active TB cases and 2312 controls matched on year of entry into service and length of service between 1990 and 2006 were compared in 2009 using multivariate conditional logistic regression. Multiple imputation methods were used to account for missing data. Results: The matched OR of active TB for military deployers as compared to nondeployers was 1.18 (95% CI=0.91, 1.52). A significant association of deployments of 90–179 days was found, but this was inconsistent with the overall negative result. Significant associations were seen with foreign birth and nonwhite racial or ethnic groups. Overseas stationing in Korea was also found to be associated with active TB. Conclusions: No strong or consistent association was found between active TB and deployment, but an association was seen with long-term residence in TB-endemic countries (Korea). The strongest risk factors for active TB in the U.S. military population were found to exist prior to accession into military service. These conclusions were robust in sensitivity analysis. [Copyright &y& Elsevier]

Hepatitis C virus (HCV) infection is the most common blood-borne infection in the United States, with estimates of 4 million HCV-infected individuals in the United States and 170 million worldwide. Most (70–80%) HCV infections persist and about 30% of individuals with persistent infection develop chronic liver disease, including cirrhosis and hepatocellular carcinoma. Epidemiological, viral and host factors have been associated with the differences in HCV clearance or persistence, and studies have demonstrated that a strong host immune response against HCV favours viral clearance. Thus, variation in genes involved in the immune response may contribute to the ability to clear the virus. In a recent genome-wide association study, a single nucleotide polymorphism (rs12979860) 3 kilobases upstream of the IL28B gene, which encodes the type III interferon IFN-λ3, was shown to associate strongly with more than a twofold difference in response to HCV drug treatment. To determine the potential effect of rs12979860 variation on outcome to HCV infection in a natural history setting, we genotyped this variant in HCV cohorts comprised of individuals who spontaneously cleared the virus (n = 388) or had persistent infection (n = 620). We show that the C/C genotype strongly enhances resolution of HCV infection among individuals of both European and African ancestry. To our knowledge, this is the strongest and most significant genetic effect associated with natural clearance of HCV, and these results implicate a primary role for IL28B in resolution of HCV infection. [ABSTRACT FROM AUTHOR]

The article presents a research study which monitored the effectiveness of intranasal live attenuated influenza vaccine and trivalent inactivated vaccine (TIV) among U.S. military service members. The study was based on surveillance of cohorts of more than a million active-duty, nonrecruit military service members aged 17 to 49 years who were stationed in the United States during the 2004-2005, 2005-2006, or 2006-2007 influenza season. Researchers found fewer medical encounters related to pneumonia and influenza with vaccination with TIV compared with LAIV or no immunization.

BACKGROUND: In South Africa, human immunodeficiency virus-1 (HIV-1) infection correlates with herpes simplex virus-2 (HSV-2; genital herpes) seropositivity in genitourinary disease clinic attendees. HSV-2 infection may be a marker for risk behavior and/or directly facilitate HIV-1 transmission. The rate of HSV-2 infection in HIV-infected South African and US blood donations was assessed, and whether the infections were correlated in donors screened and found negative for high-risk behavior by predonation interview was questioned. STUDY DESIGN AND METHODS: A total of 625 South African and 393 US HIV-1–infected repository samples previously characterized for longstanding or recent HIV-1 infection were tested with two commercially available HSV-2–specific assays. The prevalence of HSV-2 antibodies in South Africa was further assessed in 106 HIV-1–infected and 106 HIV-1–negative donors matched for sex, race, and donation history, as well as 200 random HIV-1–negative donors. RESULTS: A total of 52.2 percent of US and 69.3 percent of South African HIV-1–infected donations were HSV-2–seropositive. Age, race, and sex were independent risk factors for HSV-2 antibody prevalence in HIV-1–infected South African donors, who were more likely to be HSV-2 antibody–reactive than random HIV-1–negative donors (72.6% vs. 8.5%: odds ratio [OR], 28.6; 95% confidence interval [CI], 14.5-55) or matched donors (71.6% vs. 19.6%: OR, 10.3; 95% CI, 5.4-19.8). HIV-1 infection and HSV-2 seropositivity correlated in white and black populations when analyzed by age group. CONCLUSIONS: HIV-1 infection correlates strongly with HSV-2 seropositivity in US and South African blood donors. Our data describe the characteristics of HSV-2 antibody testing as a surrogate marker for HIV-1 infection and support a facilitating role for HSV-2 infection in HIV-1 transmission. [ABSTRACT FROM AUTHOR]

BACKGROUND: Chagas disease, caused by the parasite Trypanosoma cruzi, represents a serious blood safety problem due to increasing immigration from Latin America. The Food and Drug Administration recently recommended implementation of Chagas antibody screening for US donors as soon as a suitable assay is licensed. An anonymized preclinical study of a prototype T. cruzi lysate-based enzyme-linked immunosorbent assay (ELISA) developed by Ortho-Clinical Diagnostics was conducted. STUDY DESIGN AND METHODS: Two populations of specimens were evaluated: 1) 10,192 sequential donations from blood donors residing in the El Paso, Texas, area and 2) 178 specimens from South America which were presumptively positive for antibodies to T. cruzi and purchased from commercial vendors. RESULTS: A total of 10,189 (99.97%) of the 10,192 screened donor specimens did not react, whereas 3 (0.03%) tested initially reactive. The 3 initially reactive specimens tested repeat reactive and were confirmed by radioimmunoprecipitation analysis (RIPA). Based on antibody profile analysis, 2 of the 3 Chagas-positive specimens were from the same donor. Observed specificity of the test was therefore 100 percent. Of the specimens from South America, 173 of 178 were reactive by the prototype ELISA. Of the 5 nonreactive specimens, all did not react by indirect fluorescence assay, but 4 were positive by RIPA. Therefore, calculated sensitivity of the ELISA was 97.7 percent (173/177). CONCLUSIONS: These studies indicate that the prototype ELISA has excellent sensitivity and specificity for detection of antibodies to T. cruzi in donors. Moreover, among donations from a geographically selected collection region of the United States, observed seroprevalence was 0.03 percent. [ABSTRACT FROM AUTHOR]

National blood donor screening for West Nile virus (WNV) RNA using minipool nucleic acid amplification testing (MP-NAT) was implemented in the United States in July 2003. We compiled national NAT yield data and performed WNV immunoglobulin M (IgM) testing in 1 WNV-epidemic region (North Dakota). State-specific MP-NAT yield, antibody seroprevalence, and the average time RNA is detectable by MP-NAT were used to estimate incident infections in 2003. WNV donor screening yielded 944 confirmed viremic donors. MP-NAT yield peaked in August with >0.5% of donations positive for WNV RNA in 4 states. Peak IgM seroprevalence for North Dakota was 5.2% in late September. The average time viremia is detectable by MP-NAT was 6.9 days (95% confidence interval [CI] 3.0-10.7). An estimated 735,000 (95% CI 322,000-1,147,000) infections occurred in 2003, with 256 (95% CI 112-401) infections per neuroinvasive case. In addition to preventing transfusion-transmitted WNV infection, donor screening can serve as a tool to monitor seasonal incidence in the general population. [ABSTRACT FROM AUTHOR]

The notion of a cartogram is reviewed. Then, based on a presentation from the 1960s, a direct and simple introduction is given to the design of a computer algorithm for the construction of contiguous value-by-area cartograms. As an example, a table of latitude/longitude to rectangular plane coordinates is included for a cartogram of the United States, along with Tissot's measures for this map projection. This is followed by a short review of the subsequent history of the subject and includes citation of algorithms proposed by others. In contrast to the usual geographic map, the most common use of cartograms is solely for the display and emphasis of a geographic distribution. A second use is in analysis, as a nomograph or problem-solving device similar in use to Mercator's projection, or in the transform-solve-invert paradigm. Recent innovations by computer scientists modify the objective and suggest variation similar to Airy's (1861) “balance of errors” idea for map projections. [ABSTRACT FROM AUTHOR]

Summary 1 Salinization is a growing environmental stress in wetland ecosystems world-wide. Several models have been proposed that predict clonal plant responses to stress, including that environmental stress stimulates sexual reproduction. 2 We conducted a common-garden experiment to investigate the effects of salinity on 10 natural populations of Iris hexagona , a clonal perennial endemic to freshwater and brackish wetlands of the North American Gulf Coast. 3 Salinity reduced vegetative growth but either increased or had neutral effects on sexual reproduction, consistent with the clonal stress hypothesis. Salinity of 4 µg g[sup -1] more than doubled the number of seeds produced compared with freshwater controls, but flower number and seed mass were unaffected. 4 Salinity reduced total below-ground mass by nearly 50% compared with controls, with no significant change in rhizome numbers. 5 Plants from 10 randomly selected I. hexagona populations differed dramatically in growth and reproduction, independent of salinity. Total biomass that accumulated over the 20-month experiment ranged across all treatments from 52 to 892 g, and flower numbers varied from 2.3 to 11.3 per replicate. 6 Populations did not respond differently to salinity, except with respect to above- : below-ground ratios, thus providing no conclusive evidence for local adaptation to salinity stress. 7 Our results concur with published models of plant reproductive strategies in variable environments, in that environmental stress stimulated sexual reproduction at the expense of growth. However, these models do not predict the observed sharp decline in seed production at near lethal salinity levels. [ABSTRACT FROM AUTHOR]

BACKGROUND: In 1996, the Ortho HCV Version 3.0 ELISA Test System (HCV 3.0 EIA) was licensed in the United States for donor screening but was neither mandated nor universally implemented. Data from two studies comparing the differential performance of HCV 3.0 EIA and HCV 2.0 EIA are presented. The first study evaluated the differential performance in a cross-section of screened whole-blood donors after implementation of HCV 3.0 EIA; the second study evaluated the differential performance of HCV 3.0 EIA in plasma donors acutely infected with HCV, identified during routine Abbott HCV 2.0 EIA and HCV NAT (using Roche Ampliscreen plate assay) donor screening. STUDY DESIGN AND METHODS: The first study evaluated HCV 3.0 EIA repeat-reactive donations from four US blood centers, identified during the first 5 months of HCV 3.0 EIA implementation. HCV EIA repeat-reactive donations confirmed by RIBA HCV 3.0 SIA were retested using both Ortho HCV Version 2.0 ELISA Test System and Abbott HCV 2.0 EIA. All EIA-discordant donations were tested by polymerase chain reaction (PCR). In the second study, Abbott HCV 2.0 EIA-nonreactive, HCV PCR-positive donors were enrolled in a follow-up study in which the index and follow-up samples were re-evaluated by HCV 3.0 EIA. RESULTS: In the first study, of 292,459 donations, 501 (0.17%) confirmed HCV 3.0 EIA-reactive donations were identified; 15 (0.005%) were nonreactive by Ortho HCV 2.0 EIA and were all HCV RNA negative. In the second study, Ortho HCV 3.0 EIA retesting of Abbott HCV 2.0 EIA-nonreactive, RNA-positive index donations identified 16 (23%) as 3.0 EIA reactive. In 42 panels with a discordant time of seroconversion, HCV 3.0 EIA sero-conversion preceded HCV 2.0 EIA in all cases (p < 0.001). Two donors with HCV 3.0 EIA-reactive index donations never seroconverted by HCV 2.0 EIA during 160 to 180 days of follow-up. CONCLUSION: These studies demonstrate that HCV 3.0 EIA compared to HCV 2.0 EIA can better detect 1) remote nonviremic HCV infections, 2) acute infection, and 3) HCV antibodies in cases of atypical seroconversion. [ABSTRACT FROM AUTHOR]

Evaluates universal drug use prevention programs implemented in schools in the United States. Predictors of program effectiveness; Reduction in marijuana use; Decrease in program effectivity.

Objectives. Project DARE (Drug Abuse Resistance Education) is the most widely used school-based drug use prevention program in the United States, but the findings of rigorous evaluations of its effectiveness have not been considered collectively. Methods. We used meta-analytic techniques to review eight method-ologically rigorous DARE evaluations. Weighted effect size means for several short-term outcomes also were compared with means reported for other drug use prevention programs. Results. The DARE effect size for drug use behavior ranged from .00 to .11 across the eight studies; the weighted mean for drug use across studies was .06. For all outcomes considered, the DARE effect size means were substantially smaller than those of programs emphasizing social and general competencies and using interactive teaching strategies. Conclusions. DARE's short-term effectiveness for reducing or preventing drug use behavior is small and is less than for interactive prevention programs. [ABSTRACT FROM AUTHOR]

The article discusses a study that determined risk for West Nile virus (WNV) neuroinvasive disease (WNND) in North Dakota by testing plasma samples from blood donors for WNV immunoglobulin G (IgG). Infection rates were compared with reported WNV neuroinvasive disease incidence. It is estimated that 1 in 244 WNV infections develops into neuroinvasive disease and that risk is significantly increased among men and the elderly. It is also estimated that a total of almost 45,000 WNV infections occurred in North Dakota from its 1999 introduction to the U.S. through 2008.

Focuses on the unsuitability of nucleic acid amplification tests (NAT) in detecting very low level viremia in Hepatitis C virus (HCV) infectious unit, as of August 2003. Account of NAT systems licensed by the U.S. Food and Drug Administration for HCV and HIV-RNA screening of source plasma and blood donors; Suspicion regarding the efficacy of these NAT systems for detecting HCV-RNA in retained plasma; Overview of method through which low-level HCV viremia could be detected.

Background: Nucleic acid testing (NAT) has been performed on virtually all blood collected in the US since early 1999. Due to the absence of a licensed HCV supplemental NAT assay (SupNAT), an in-house assay was developed with 100 copies/mL (100% detection rate) sensitivity. Methods: The HCV supplemental NAT assay incorporated a guanidinium based lysis of 0.5mL of plasma followed by concentration of RNA using magnetized silica beads. HCV RNA was detected using the Roche COBAS Amplicor HCV version 2.0 reagents. This assay was employed primarily to confirm seronegative (EIA)/NAT positive and seropositive (EIA+)/NAT negative index samples identified in the Chiron Procleixä Clinical Trial as well as F/U samples. Some concordant samples were also tested. Results: From 8/25/00 through 4/30/01, 1,941,285 samples were evaluated using the Chiron Procleixä HIV-1/HCV Assay in both clinical (high prevalence) and donor (low prevalence) settings. The Supplemental NAT laboratory received and tested a total of 523 (0.03%) samples [205(40%) clinical and 318(60%) donor]. SupNAT confirmed Procleixä in 99% of all clinical samples received [12.1% HCV EIA-/SupNAT+ and 87.9% were EIA+/SupNAT+]. In comparison 99% of all samples received from donor sites were confirmed by SupNAT [4% HCV EIA-/SupNAT+ and 96% were EIA+/SupNAT-]. A total of 35 (8 donor and 27 clinical) F/U samples had enough volume for NAT testing. SupNAT results on clinical index samples were confirmed by F/U in 26/27 cases. In all 8 donor cases with F/U samples the index NAT/SupNAT results could not be confirmed by F/U, indicating the initial NAT result was due to tube contamination at the blood center. Conclusions: These data indicate that the Sup NAT assay was appropriate for confirmation of screening NAT assay results. [ABSTRACT FROM AUTHOR]

Musculoskeletal disorders (MSDs) account for almost 70 million physician office visits per year in the United States and are the most common workplace injuries. These are conditions involving the nerves, tendons, muscles, and supporting structures of the body. Previous studies have concluded that computer users are at high risk of developing work-related musculoskeletal disorders (WRMSDs). As computer users, medical dosimetrists are at risk of developing WRMSDs, yet there is a lack of information regarding the incidence of WRMSDs among medical dosimetrists. The purpose of this study was to determine the incidence of WRMSDs and variables of workstation ergonomics that contribute to the increased risk of WRMSDs in medical dosimetrists. A Qualtrics survey was created to support the 3 research questions guiding this study. The survey was distributed to 2,646 full members of the American Association of Medical Dosimetrists (AAMD), which included only certified medical dosimetrists (CMDs), via email. The distribution of email surveys sent through the AAMD email distribution list resulted in 988 emails opened, for a contact rate of 37% (988/2646). One hundred sixty-four responses were recorded yielding a completion rate of 17% (164/988). Fifty-five percent (90/163) of participants responded that they have experienced WRMSDs. Forty-four percent (289/652) of responses indicated WRMSDs have a slight or moderate interference on work. Sixty-two percent (94/152) of participants felt that their workstations were not ergonomically designed; even greater 68% (104/153) did not feel their workstations were designed for their individually needs. Of those respondents 64% (98/152) would like to see further adaptations made to their workspaces. [ABSTRACT FROM AUTHOR]

The Pecos gambusia (Gambusia nobilis) is an endangered poeciliid native to western Texas and eastern New Mexico. The decline of G. nobilis in Texas is likely the result of habitat alteration and introduction of potentially invasive congeners (e.g., the introduced largespring gambusia, Gambusia geiseri). In the East Sandia Cienega, observers have noted mating between G. geiseri and G. nobilis. Because potential hybridization between native and introduced species could have detrimental effects on reproductive fitness, we compare mean brood size, gonadosomatic indices, and standard length of both G. geiseri and G. nobilis as a first step in assessing the impacts of G. geiseri introduction in this area. [ABSTRACT FROM AUTHOR]

Malaria was eradicated and the Republic of Korea (ROK) declared "malaria free" in 1979. However, in 1993, a temperate strain of vivax malaria, expressing both latent and nonlatent disease populations, re-emerged near the demilitarized zone (DMZ), rapidly spread to civilian sectors near the DMZ, and increased exponentially in ROK military, veteran, and civilian populations through 1998. Malaria among all ROK populations decreased 5-fold from a high of 4142 cases in 2000 to a low of 826 cases in 2004, before increasing again to 2180 cases by 2007. Each malaria case in the ROK is reported in the metropolitan area/province where the diagnosis is made, which may be at some distance from the area where infection occurred. Therefore, it is difficult to ascertain transmission sites since approximately 60% of vivax malaria in Korea is latent with symptoms occurring >1 month to 24 months after infection. A review of case diagnosis for civilian, veteran, and military populations shows that nearly all malaria south of Gyeonggi and Gangwon Provinces is the result of veterans exposed in malaria high-risk areas along the DMZ and returning to their hometowns where they later develop malaria. Thus, malaria currently remains localized near the DMZ with limited transmission in provinces south of Seoul and has not spread throughout Korea as previously hypothesized. This report describes the reemergence of vivax malaria cases in civilian and military ROK populations and U.S. military personnel and assesses variables related to its transmission and geographic distribution. [ABSTRACT FROM AUTHOR]

Malaria was eradicated and the Republic of Korea (ROK) declared "malaria free" in 1979. However, in 1993, a temperate strain of vivax malaria, expressing both latent and nonlatent disease populations, re-emerged near the demilitarized zone (DMZ), rapidly spread to civilian sectors near the DMZ, and increased exponentially in ROK military, veteran, and civilian populations through 1998. Malaria among all ROK populations decreased 5-fold from a high of 4,142 cases in 2000 to a low of 826 cases in 2004, before increasing again to 2,180 cases by 2007. Each malaria case in the ROK is reported in the metropolitan area/province where the diagnosis is made, which may be at some distance from the area where infection occurred. Therefore, it is difficult to ascertain transmission sites since approximately 60% of vivax malaria in Korea is latent with symptoms occurring >1 month to 24 months after infection. A review of case diagnosis for civilian, veteran, and military populations shows that nearly all malaria south of Gyeonggi and Gangwon Provinces is the result of veterans exposed in malaria high-risk areas along the DMZ and returning to their hometowns where they later develop malaria. Thus, malaria currently remains localized near the DMZ with limited transmission in provinces south of Seoul and has not spread throughout Korea as previously hypothesized. This report describes the reemergence of vivax malaria cases in civilian and military ROK populations and U.S. military personnel and assesses variables related to its transmission and geographic distribution. [ABSTRACT FROM AUTHOR]

Abstract: Limited effectiveness data are available comparing live attenuated influenza vaccine (LAIV) to inactivated influenza vaccine (TIV) among adults. To compare the incidence of influenza-like illness following immunization of adults with LAIV vs. TIV, we conducted a retrospective cohort analysis of active component U.S. military personnel for the 2005–2006 and 2006–2007 influenza seasons. Recruits experienced a much higher burden of disease compared to non-recruits, with crude incidence rates of influenza-like illness 2–16 times higher than non-recruits depending on the season and cohort. For both seasons, a slightly greater protection from influenza-like illness was found for non-recruits who received TIV compared to LAIV (adjusted incidence rate ratio, 1.17 (95% CI, 1.14–1.20) and 1.33 (95% CI, 1.30–1.36), 2005–2006 and 2006–2007 influenza seasons, respectively). However, for Army and Air Force recruits, LAIV was found to provide significantly greater protection from influenza-like illnesses compared to TIV, with adjusted incidence rates of influenza-like illness 22–51% and 18–47% lower among LAIV compared to TIV recipients for the 2005–2006 and 2006–2007 influenza seasons, respectively. Possible reasons for differences in recruit and non-recruit findings include differences in pre-existing influenza antibody levels, differing respiratory disease burden, and/or unmeasured confounding. Consideration of these findings should be made when developing influenza immunization policies. [Copyright &y& Elsevier]

Military personnel serving at remote camps in the border regions of northeastern Afghanistan may experience crowded living conditions and may have frequent interaction with local national (LN) workers, increasing the risk of exposure to multiple endemic diseases including tuberculosis (TB). In January 2007, pulmonary TB was clinically suspected in a LN worker who had close contact with a company of 92 U.S. Army personnel at a remote camp in Konar province, Afghanistan. over 4 months. This report describes the results of the contact investigation conducted by the U.S. Army, in which four U.S. personnel were found to have evidence of TB exposure. This investigation raises concerns arising from the high prevalence of drag-resistant TB in the region and in neighboring North West Frontier Province. Pakistan, and demonstrates the challenges of conducting contact investigations and using LN workers in deployed wartime environments. [ABSTRACT FROM AUTHOR]

Abstract: Problem: Hundreds of laws have been implemented in the United States over the past few decades designed to reduce alcohol-impaired driving and the crashes that often result. One approach has been to lower the legally allowable alcohol concentration for drivers. We examined the effects of changes in legal BAC limit in 28 U.S. states from January, 1976 to December, 2002. Method: An interrupted time-series quasi-experimental design was used, incorporating non-alcohol-related crashes as comparisons. Four outcome measures of alcohol-related crash involvement were examined: single-vehicle nighttime, BAC=0.01–0.07, BAC=0.08–0.14, and BAC≥0.15. Missing BAC test result data were handled by using multiple imputations. Analyses involved estimation of state-specific ARIMA models, controlling for other factors affecting overall crash rates and other major DUI policy changes. Inverse variance weighting methods were used to pool results across states for the most precise underlying estimate of effect of legal BAC limits. Results: Considerable state by state variability in estimated effects was observed, but results from the pooled analyses were clear and consistent. Changes in legal BAC limits significantly affected alcohol-related fatal crash involvement for both the SVN and BAC test result measures, and the laws affected drivers at all drinking levels. Summary: An estimated 360 deaths are prevented each year in the United States as a result of the move from a 0.10 to 0.08 legal limit in recent years, and an additional 538 lives could be saved each year if the United States reduced the limit to 0.05, consistent with limits in most countries worldwide. Impact on Industry: Given the significant effects of lower legal BAC limits on fatal crash involvement, businesses should support implementation of laws that further reduce the legal BAC limit for all drivers. Furthermore, all companies should set higher standards for employees, such as a zero allowable BAC limit for driving during work time. [Copyright &y& Elsevier]

Background: There is growing optimism regarding the use of screening and brief intervention (SBI) to identify and reduce risk behaviors during adolescence. However, understanding successful SBI implementation remains unclear. We previously reported the effects of CONNECT, a school-based SBI, on reducing the primary outcome, the rate of monthly alcohol use among primarily American Indian (AI) and White high school students in the Cherokee Nation. In this paper, we describe the design and implementation process for CONNECT., Method: CONNECT was designed to reduce alcohol use with 2 key strategies: (1) SBI with motivational interviewing (MI), implemented by a school-based CONNECT coach, and (2) a media campaign., Results: Implementation results indicate that during each semester of the 2-1/2 years, between 73% and 100% of eligible students had at least one 15-minute meeting with a CONNECT coach. Postcards and posters with positive communication tips for parents were displayed in CONNECT communities. No statistically significant differences occurred between the CONNECT and control groups on the hypothesized intermediate outcomes., Conclusions: We describe implementation of a universal, school-based, culturally adapted SBI that was effective in reducing alcohol use among youth living in the Cherokee Nation. Schools provide an important context for universal delivery of SBI interventions, such as CONNECT, for diverse adolescent populations, including AI youth., (© 2019, American School Health Association.)