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1
Garrett-Cherry, Tiana A., Andrew K. Hennenfent, Sasha McGee, and John Davies-Cole. "Enhanced One Health Surveillance during the 58th Presidential Inauguration—District of Columbia, January 2017." Disaster Medicine and Public Health Preparedness 14, no. 2 (2019): 201–7. http://dx.doi.org/10.1017/dmp.2019.38.
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ABSTRACTObjective:In January 2017, Washington, DC, hosted the 58th United States presidential inauguration. The DC Department of Health leveraged multiple health surveillance approaches, including syndromic surveillance (human and animal) and medical aid station–based patient tracking, to detect disease and injury associated with this mass gathering.Methods:Patient data were collected from a regional syndromic surveillance system, medical aid stations, and an internet-based emergency department reporting system. Animal health data were collected from DC veterinary facilities.Results:Of 174 703 chief complaints from human syndromic data, there were 6 inauguration-related alerts. Inauguration attendees who visited aid stations (n = 162) and emergency departments (n = 180) most commonly reported feeling faint/dizzy (n = 29; 17.9%) and pain/cramps (n = 34;18.9%). In animals, of 533 clinical signs reported, most were gastrointestinal (n = 237; 44.5%) and occurred in canines (n = 374; 70.2%). Ten animals that presented dead on arrival were investigated; no significant threats were identified.Conclusion:Use of multiple surveillance systems allowed for near-real-time detection and monitoring of disease and injury syndromes in humans and domestic animals potentially associated with inaugural events and in local health care systems.
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Kuramoto-Crawford, S. Janet, Erica L. Spies, and John Davies-Cole. "Detecting Suicide-Related Emergency Department Visits Among Adults Using the District of Columbia Syndromic Surveillance System." Public Health Reports 132, no. 1_suppl (2017): 88S—94S. http://dx.doi.org/10.1177/0033354917706933.
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Objectives: Limited studies have examined the usefulness of syndromic surveillance to monitor emergency department (ED) visits involving suicidal ideation or attempt. The objectives of this study were to (1) examine whether syndromic surveillance of chief complaint data can detect suicide-related ED visits among adults and (2) assess the added value of using hospital ED data on discharge diagnoses to detect suicide-related visits. Methods: The study data came from the District of Columbia electronic syndromic surveillance system, which provides daily information on ED visits at 8 hospitals in Washington, DC. We detected suicide-related visits by searching for terms in the chief complaints and discharge diagnoses of 248 939 ED visits for which data were available for October 1, 2015, to September 30, 2016. We examined whether detection of suicide-related visits according to chief complaint data, discharge diagnosis data, or both varied by patient sex, age, or hospital. Results: The syndromic surveillance system detected 1540 suicide-related ED visits, 950 (62%) of which were detected through chief complaint data and 590 (38%) from discharge diagnosis data. The source of detection for suicide-related ED visits did not vary by patient sex or age. However, whether the suicide-related terms were mentioned in the chief complaint or discharge diagnosis differed across hospitals. Conclusions: ED syndromic surveillance systems based on chief complaint data alone would underestimate the number of suicide-related ED visits. Incorporating the discharge diagnosis into the case definition could help improve detection.
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Watson, Jacqueline A., and Deniz Soyer. "A State Medical Board's Assessment of its Physician Workforce Capacity: Purpose, Process, Perspective and Lessons Learned." Journal of Medical Regulation 99, no. 4 (2013): 10–19. http://dx.doi.org/10.30770/2572-1852-99.4.10.
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ABSTRACT The District of Columbia Board of Medicine (D.C. Board), a division within the District of Columbia Department of Health, Health Regulation and Licensing Administration, regulates more than 12,000 health care professionals — physicians, physician assistants, acupuncturists, anesthesiologist assistants, naturopathic physicians, polysomnographers, and surgical assistants — licensed in the District of Columbia. Recognizing that the licensure renewal period, conducted every two years on even numbered years, presented a unique opportunity to collect data for workforce research and analysis, the D.C. Board embarked in 2010 upon a three-phased project designed to collect demographic and practice characteristic information on licensed physicians and physician assistants under the Board's purview. A multidisciplinary workforce workgroup was assembled by the D.C. Board and tasked with developing survey questions and a method of data collection. The Health Resources and Services Administration's National Center for Workforce Analysis Minimum Data Set was used as a guide in developing the survey. The surveys were voluntary, and elicited a 78% response rate and a 58% response rate for physicians in 2010 and 2012, respectively. This article summarizes the results of the District's Physician Workforce Reports, focusing on the physician data collected. The article outlines the process the D.C. Board used in compiling the reports, and offers perspective on the project for other state medical boards as they consider launching their own workforce data-gathering efforts. The article does not examine or draw conclusions about data for physician assistants.
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Hahn, Micah B., Rebecca J. Eisen, Lars Eisen, et al. "Reported Distribution of Aedes (Stegomyia) aegypti and Aedes (Stegomyia) albopictus in the United States, 1995-2016 (Diptera: Culicidae)." Journal of Medical Entomology 53, no. 5 (2016): 1169–75. http://dx.doi.org/10.1093/jme/tjw072.
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Abstract Aedes (Stegomyia) aegypti (L.) and Aedes (Stegomyia) albopictus (Skuse) transmit arboviruses that are increasing threats to human health in the Americas, particularly dengue, chikungunya, and Zika viruses. Epidemics of the associated arboviral diseases have been limited to South and Central America, Mexico, and the Caribbean in the Western Hemisphere, with only minor localized outbreaks in the United States. Nevertheless, accurate and up-to-date information for the geographical ranges of Ae. aegypti and Ae. albopictus in the United States is urgently needed to guide surveillance and enhance control capacity for these mosquitoes. We compiled county records for presence of Ae. aegypti and Ae. albopictus in the United States from 1995-2016, presented here in map format. Records were derived from the Centers for Disease Control and Prevention ArboNET database, VectorMap, the published literature, and a survey of mosquito control agencies, university researchers, and state and local health departments. Between January 1995 and March 2016, 183 counties from 26 states and the District of Columbia reported occurrence of Ae. aegypti, and 1,241 counties from 40 states and the District of Columbia reported occurrence of Ae. albopictus. During the same time period, Ae. aegypti was collected in 3 or more years from 94 counties from 14 states and the District of Columbia, and Ae. albopictus was collected during 3 or more years from 514 counties in 34 states and the District of Columbia. Our findings underscore the need for systematic surveillance of Ae. aegypti and Ae. albopictus in the United States and delineate areas with risk for the transmission of these introduced arboviruses.
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Amy, choeffel. "Medicaid & Medicare: D.C. Appellate Court Denies Claim for Medicare Reimbursement of GME Cost." Journal of Law, Medicine & Ethics 27, no. 2 (1999): 205. http://dx.doi.org/10.1017/s1073110500012997.
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The U.S. Court of Appeals for the District of Columbia upheld, in Presbyterian Medical Center of the University of Pennsylvania Health System v. Shalala, 170 F.3d 1146 (D.C. Cir. 1999), a federal district court ruling granting summary judgment to the Department of Health and Human Services (DHHS) in a case in which Presbyterian Medical Center (PMC) challenged Medicare's requirement of contemporaneous documentation of $828,000 in graduate medical education (GME) expenses prior to increasing reimbursement amounts. DHHS Secretary Donna Shalala denied PMC's request for reimbursement for increased GME costs. The appellants then brought suit in federal court challenging the legality of an interpretative rule that requires requested increases in reimbursement to be supported by contemporaneous documentation. PMC also alleged that an error was made in the administrative proceedings to prejudice its claims because Aetna, the hospital's fiscal intermediary, failed to provide the hospital with a written report explaining why it was denied the GME reimbursement.
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Jenkins, Amelia A., James Leigh Jenkins, and James Patton. "State Certification Standards for Teachers of Students with Learning Disabilities: An Update." Learning Disability Quarterly 20, no. 4 (1997): 266–79. http://dx.doi.org/10.2307/1511225.
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This study is an update of an earlier nationwide survey of state certification standards for teachers of students with learning disabilities conducted in conjunction with the Standards and Ethics Committee of the Council for Learning Disabilities (Leigh & Patton, 1986). Information was received from every state department and the District of Columbia teacher certification office. Data were analyzed and tabulated to include: (a) certification categories (titles) and level(s); (b) teacher training requirements (i.e., courses, standards, and hours); (c) examination requirements for certification; and (d) other additional information. The results are discussed in the context of relevant issues and trends and the relationship to the findings of the previous study.
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Kois, Lauren E., Kortney Hill, Lauren Gonzales, Shelby Hunter, and Preeti Chauhan. "Correctional Officer Mental Health Training: Analysis of 52 U.S. Jurisdictions." Criminal Justice Policy Review 31, no. 4 (2019): 555–72. http://dx.doi.org/10.1177/0887403419849624.
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Research indicates correctional officer (CO) mental health training may be effective in facilitating the safety and security of both inmates and COs. We assessed Department of Corrections’ CO preservice (requisite for beginning an official post) mental health training requirements in 50 states, the District of Columbia, and the Federal Bureau of Prisons. We obtained information regarding instruction method, training duration, and courses required. Descriptive statistics showed that all jurisdictions require mental health training, ranging from 1.5 to 80 hr ( M = 13.54, SD = 14.58, Mdn = 8). When considering course titles, the most common course topic is crisis intervention ( n = 44, 84.62%). The next most frequent course topics are general psychoeducation ( n = 24, 46.15%), special populations ( n = 12, 23.08%), specific clinical interventions ( n = 7, 13.46%), institutional procedure specific to mental health ( n = 6, 11.54%), and CO mental health and self-care ( n = 4, 7.69%). Future research should examine whether CO mental health training is related to positive mental health outcomes and other important institutional metrics, as well as variations in training and its impact at the national and international levels.
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Carpenter, Joseph E., Arthur S. Chang, Alvin C. Bronstein, Richard G. Thomas, and Royal K. Law. "Identifying Incidents of Public Health Significance Using the National Poison Data System, 2013–2018." American Journal of Public Health 110, no. 10 (2020): 1528–31. http://dx.doi.org/10.2105/ajph.2020.305842.
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Data System. The American Association of Poison Control Centers (AAPCC) and the Centers for Disease Control and Prevention (CDC) jointly monitor the National Poison Data System (NPDS) for incidents of public health significance (IPHSs). Data Collection/Processing. NPDS is the data repository for US poison centers, which together cover all 50 states, the District of Columbia, and multiple territories. Information from calls to poison centers is uploaded to NPDS in near real time and continuously monitored for specific exposures and anomalies relative to historic data. Data Analysis/Dissemination. AAPCC and CDC toxicologists analyze NPDS-generated anomalies for evidence of public health significance. Presumptive results are confirmed with the receiving poison center to correctly identify IPHSs. Once verified, CDC notifies the state public health department. Implications. During 2013 to 2018, 3.7% of all NPDS-generated anomalies represented IPHSs. NPDS surveillance findings may be the first alert to state epidemiologists of IPHSs. Data are used locally and nationally to enhance situational awareness during a suspected or known public health threat. NPDS improves CDC’s national surveillance capacity by identifying early markers of IPHSs.
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Jonas, Richard A., and Gerard R. Martin. "The evolution of cardiac care for children in Washington, DC." Cardiology in the Young 31, no. 8 (2021): 1220–27. http://dx.doi.org/10.1017/s1047951121003486.
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AbstractCardiac surgery for CHD was pioneered in Washington, DC by Charles Hufnagel and Edgar Davis working at Georgetown University and Children’s Hospital of the District of Columbia. Children’s Hospital, now Children’s National Hospital, had been established just 5 years after the end of the Civil War. In the 1950s, Davis and Hufnagel undertook many open-heart operations using the technique of surface cooling, hypothermia, and circulatory arrest. Hufnagel and Lewis Scott, who founded the cardiology department at Children’s, were trained in Boston by Gross and Nadas. Judson Randolph, also a trainee of Gross, introduced cardiac surgery using cardiopulmonary bypass and established the General Pediatric Surgery department at Children’s in the 1960s. The transition of hospital staffing from community-based private physicians to full-time hospital employees was often controversial but was complete by the turn of the millennium. The 21st century has seen continuing growth of the new Children’s National Heart Institute and consolidation of several congenital cardiac programmes in Washington, DC.
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Mann, Edana, Daniel Swedien, Jonathan Hansen, et al. "Reduction in Emergency Department Presentations in a Regional Health System during the Covid-19 Pandemic." Western Journal of Emergency Medicine 22, no. 4 (2021): 842–50. http://dx.doi.org/10.5811/westjem.2020.10.49759.
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Introduction: Nationally, there has been more than a 40% decrease in Emergency Department (ED) patient volume during the coronavirus disease 2019 (Covid-19) crisis, with reports of decreases in presentations of time-sensitive acute illnesses. We analyzed ED clinical presentations in a Maryland/District of Columbia regional hospital system while health mitigation measures were instituted. Methods: We conducted a retrospective observational cohort study of all adult ED patients presenting to five Johns Hopkins Health System (JHHS) hospitals comparing visits from March 16 through May 15, in 2019 and 2020. We analyzed de-identified demographic information, clinical conditions, and ICD-10 diagnosis codes for year-over-year comparisons. Results: There were 36.7% fewer JHHS ED visits in 2020 compared to 2019 (43,088 vs. 27,293, P<.001). Patients 75+ had the greatest decline in visits (-44.00%, P<.001). Both genders had significant decreases in volume (-41.9%, P<.001 females vs -30.6%, P<.001 males). Influenza like illness (ILI) symptoms increased year-over-year including fever (640 to 1253, 95.8%, P<.001) and shortness of breath (2504 to 2726, 8.9%, P=.002). ICD-10 diagnoses for a number of time-sensitive illnesses decreased including deep vein thrombosis (101 to 39, -61%, P<.001), acute myocardial infarction (157 to 105, -33%, P=.002), gastrointestinal bleeding (290 to 179, -38.3%, P<.001), and strokes (284 to 234, -17.6%, P=0.03). Conclusion: ED visits declined significantly among JHHS hospitals despite offsetting increases in ILI complaints. Decreases in presentations of time-sensitive illnesses were of particular concern. Efforts should be taken to inform patients that EDs are safe, otherwise preventable morbidity and mortality will remain a problem.
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Arrazola, Jessica, Mia N. Israel, and Nancy Binkin. "Applied Epidemiology Workforce Growth and Capacity Challenges: The Council of State and Territorial Epidemiologists 2017 Epidemiology Capacity Assessment." Public Health Reports 134, no. 4 (2019): 379–85. http://dx.doi.org/10.1177/0033354919849887.
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Objectives: To better understand the current status and challenges of the state public health department workforce, the Council of State and Territorial Epidemiologists (CSTE) assessed the number and functions of applied public health epidemiologists at state health departments in the United States. Methods: In 2017, CSTE emailed unique online assessment links to state epidemiologists in the 50 states and the District of Columbia (N = 51). The response rate was 100%. CSTE analyzed quantitative data (27 questions) on funding, the number of current and needed epidemiologists, recruitment, retention, perceived capacity, and training. CSTE coded qualitative data in response to an open-ended question that asked about the most important problems state epidemiologists face. Results: Most funding for epidemiologic activities came from the federal government (mean, 77%). State epidemiologists reported needing 1199 additional epidemiologists to achieve ideal capacity but noted challenges in recruiting qualified staff members. Respondents cited opportunities for promotion (n = 45, 88%), salary (n = 41, 80%), restrictions on merit raises (n = 36, 70%), and losses to the private or government sector (n = 33, 65%) as problems for retention. Of 4 Essential Public Health Services measured, most state epidemiologists reported substantial-to-full capacity to monitor health status (n = 43, 84%) and diagnose and investigate community health problems (n = 47, 92%); fewer respondents reported substantial-to-full capacity to conduct evaluations (n = 20, 39%) and research (n = 11, 22%). Conclusions: Reliance on federal funding negatively affects employee retention, core capacity, and readiness at state health departments. Creative solutions for providing stable funding, developing greater flexibility to respond to emerging threats, and enhancing capacity in evaluation and applied research are needed.
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Mellerson, Jenelle L., Erica Street, Cynthia Knighton, Kayla Calhoun, Ranee Seither, and J. Michael Underwood. "Centers for Disease Control and Prevention’s School Vaccination Assessment: Collaboration With US State, Local, and Territorial Immunization Programs, 2012–2018." American Journal of Public Health 110, no. 7 (2020): 1092–97. http://dx.doi.org/10.2105/ajph.2020.305643.
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Objectives. To describe the ongoing collaboration of the Centers for Disease Control and Prevention’s (CDC’s) school vaccination assessment with state, local, and territorial immunization programs to provide data to monitor school entry vaccination. Methods. Departments of health and education partner to collect data from public school, private school, and homeschooled kindergartners in the 50 US states, the District of Columbia, 2 cities, and the US territories. Immunization programs submit vaccination coverage and exemption data to the CDC, and the CDC reports these data annually via multiple sources. Results. Among the 50 states and the District of Columbia, the number of programs using a census for vaccination coverage data increased from 39 to 41 during the school years 2012–2013 to 2017–2018 (which for most states was August or September through May or June), and the number using a census to collect exemption data increased from 40 to 46. The number of states that reported sharing their local-level vaccination coverage data online increased from 11 in 2012–2013 to 31 in 2017–2018. Conclusions. Coverage data can be used to address undervaccination among kindergartners to work with communities and schools that are susceptible to vaccine-preventable diseases. As more states publish local-level data online, access to improved data provides the public more valuable information.
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Horn, Kimberly, Sallie Beth Johnson, Sofía Rincón-Gallardo Patiño, et al. "Implementation of the Department of Housing and Urban Development’s Smoke-Free Rule: A Socio-Ecological Qualitative Assessment of Administrator and Resident Perceptions." International Journal of Environmental Research and Public Health 18, no. 17 (2021): 8908. http://dx.doi.org/10.3390/ijerph18178908.
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In July 2018, the United States Department of Housing and Urban Development (HUD) implemented a mandatory smoke-free rule in public housing. This study assessed administrator and resident perceptions of rule implementation during its initial year in the District of Columbia Housing Authority (DCHA). Assessment included nine focus groups (n = 69) with residents and in-depth interviews with administrators (n = 7) and residents (n = 26) from 14 DCHA communities (family = 7 and senior/disabled = 7). Semi-structured discussion guides based on the multi-level socio-ecological framework captured dialogue that was recorded, transcribed verbatim, and coded inductively. Emerging major themes for each socio-ecological framework level included: (1) Individual: the rule was supported due to perceived health benefits, with stronger support among non-smokers; (2) Interpersonal: limiting secondhand smoke exposure was perceived as a positive for vulnerable residents; (3) Organizational: communication, signage, and cessation support was perceived as a need; (4) Community: residents perceived mobility, disability, weather, and safety-related issues as barriers; and (5) Public Policy: lease amendments were perceived as enablers of rule implementation but expressed confusion about violations and enforcement. A majority of administrators and residents reported favorable implications of the mandated HUD rule. The novel application of a socio-ecological framework, however, detected implementation nuances that required improvements on multiple levels, including more signage, cessation support, clarification of enforcement roles, and addressing safety concerns.
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Sipsma, Heather L., Maureen E. Canavan, Erika Rogan, Lauren A. Taylor, Kristina M. Talbert-Slagle, and Elizabeth H. Bradley. "Spending on social and public health services and its association with homicide in the USA: an ecological study." BMJ Open 7, no. 10 (2017): e016379. http://dx.doi.org/10.1136/bmjopen-2017-016379.
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ObjectiveTo examine whether state-level spending on social and public health services is associated with lower rates of homicide in the USA.DesignEcological study.SettingUSA.ParticipantsAll states in the USA and the District of Columbia for which data were available (n=42).Primary outcome measureHomicide rates for each state were abstracted from the US Department of Justice Federal Bureau of Investigation’s Uniform Crime Reporting.ResultsAfter adjusting for potential confounding variables, we found that every $10 000 increase in spending per person living in poverty was associated with 0.87 fewer homicides per 100 000 population or approximately a 16% decrease in the average homicide rate (estimate=−0.87, SE=0.15, p<0.001). Furthermore, there was no significant effect in the quartile of states with the highest percentages of individuals living in poverty but significant effects in the quartiles of states with lower percentages of individuals living in poverty.ConclusionsBased on our findings, spending on social and public health services is associated with significantly lower homicide rates at the state level. Although we cannot infer causality from this research, such spending may provide promising avenues for homicide reduction in the USA, particularly among states with lower levels of poverty.
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Powell, Krista, Molly M. Lamb, Mary K. Sisk, et al. "Passenger Contact Investigation Associated with a Transport Driver with Pulmonary Tuberculosis." Public Health Reports 127, no. 2 (2012): 202–7. http://dx.doi.org/10.1177/003335491212700209.
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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.
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Latshaw, Megan Weil, Chris Mangal, Anthony Barkey, Doug McNamara, Deborah Kim, and Jennifer Beck Pierson. "Public Health Laboratories and Radiological Readiness." Disaster Medicine and Public Health Preparedness 5, no. 3 (2011): 213–17. http://dx.doi.org/10.1001/dmp.2011.63.
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ABSTRACTObjective: To document the ability of public health laboratories to respond to radiological emergencies.Methods: The Association of Public Health Laboratories developed, distributed, and analyzed two separate surveys of public health laboratories representing the 50 US states and major nonstate jurisdictions. The 2009 All-Hazards Laboratory Preparedness Survey examined overall laboratory capability and capacity, with a subset of questions on radiation preparedness. A 2011 survey focused exclusively on radiation readiness.Results: The 50 state and District of Columbia public health laboratories responded to the 2009 All-Hazards Laboratory Preparedness Survey, representing a 98% response rate. In addition to the above laboratories, environmental and agricultural laboratories responded to the 2011 Radiation Capabilities Survey, representing a 76% response rate. Twenty-seven percent of the All-Hazards Survey respondents reported the ability to measure radionuclides in clinical specimens; 6% reported that another state agency or department accepted and analyzed these samples via a radioanalytical method. Of the Radiation Capabilities Survey respondents, 60% reported the ability to test environmental samples, such as air, soil, or surface water, for radiation; 48% reported the ability to test nonmilk food samples; 47% reported the ability to test milk; and 56% reported sending data for drinking water to the Environmental Protection Agency.Conclusions: Survey data reveal serious gaps in US radiological preparedness. In 2007, federal experts estimated it would take more than 4 years to screen 100 000 individuals for radiation exposure and 6 years to test environmental samples from a large-scale radiological emergency, relying on existing laboratory assets. Although some progress has been made since 2007, public health laboratory radiological test capabilities and capacities remain insufficient to respond to a major event. Adequate preparation requires significant new investment to build and enhance laboratory emergency response networks, as well as investments in the broader public health system in which public health laboratories function.(Disaster Med Public Health Preparedness. 2011;5:213-217)
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Adams, William M., Samantha E. Scarneo, and Douglas J. Casa. "Assessment of Evidence-Based Health and Safety Policies on Sudden Death and Concussion Management in Secondary School Athletics: A Benchmark Study." Journal of Athletic Training 53, no. 8 (2018): 756–67. http://dx.doi.org/10.4085/1062-6050-220-17.
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Context: Implementation of best-practice health and safety policies has been shown to be effective at reducing the risk of sudden death in sport; however, little is known about the extent to which these policies are required within secondary school athletics.Objective: To examine best-practice health and safety policies pertaining to the leading causes of sudden death and to concussion management in sport mandated at the state level for secondary school athletics.Design: Descriptive observational study.Setting: State high school athletic associations (SHSAAs), state departments of education, and enacted legislation.Patients or Other Participants: United States (including the District of Columbia) SHSAAs.Main Outcome Measure(s): A review of SHSAA health and safety policies for the 2016–2017 academic year, state department of education policies, and enacted legislation was undertaken to assess the polices related to the leading causes of sudden death and concussion management in sport. Current best-practice recommendations used to assess health and safety policies were specific to emergency action plans, automated external defibrillators, heat acclimatization, environmental monitoring and modification, and concussion management. The total number of best-practice recommendations required for each SHSAA's member schools for the aforementioned areas was quantified and presented as total number and percentage of recommendations required.Results: Four of 51 SHSAA member schools were required to follow best practices for emergency action plans, 7 of 51 for access to automated external defibrillators, 8 of 51 for heat acclimatization, and 3 of 51 for management of concussion.Conclusions: At the time of this study, SHSAA member schools were not required to follow all best-practice recommendations for preventing the leading causes of sudden death and for concussion management in sport. Continued advocacy for the development and implementation of best practices at the state level to be required of all secondary schools is needed to appropriately serve the health and well-being of our young student-athletes.
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Firew, Tsion, Ellen D. Sano, Jonathan W. Lee, et al. "Protecting the front line: a cross-sectional survey analysis of the occupational factors contributing to healthcare workers’ infection and psychological distress during the COVID-19 pandemic in the USA." BMJ Open 10, no. 10 (2020): e042752. http://dx.doi.org/10.1136/bmjopen-2020-042752.
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ObjectiveThe COVID-19 pandemic has been associated with significant occupational stressors and challenges for front-line healthcare workers (HCWs), including COVID-19 exposure risk. Our study sought to assess factors contributing to HCW infection and psychological distress during the COVID-19 pandemic in the USA.DesignWe conducted a cross sectional survey of HCWs (physicians, nurses, emergency medical technicians (EMTs), non-clinical staff) during May 2020. Participants completed a 42-item survey assessing disease transmission risk (clinical role, work environment, availability of personal protective equipment) and mental health (anxiety, depression and burn-out).SettingThe questionnaire was disseminated over various social media platforms. 3083 respondents from 48 states, the District of Columbia and US territories accessed the survey.ParticipantsUsing a convenience sample of HCWs who worked during the pandemic, 3083 respondents accessed the survey and 2040 participants completed at least 80% of the survey.Primary outcomePrevalence of self-reported COVID-19 infection, in addition to burn-out, depression and anxiety symptoms.ResultsParticipants were largely from the Northeast and Southern USA, with attending physicians (31.12%), nurses (26.80%), EMTs (13.04%) with emergency medicine department (38.30%) being the most common department and specialty represented. Twenty-nine per cent of respondents met the criteria for being a probable case due to reported COVID-19 symptoms or a positive test. HCWs in the emergency department (31.64%) were more likely to contract COVID-19 compared with HCWs in the ICU (23.17%) and inpatient settings (25.53%). HCWs that contracted COVID-19 also reported higher levels of depressive symptoms (mean diff.=0.31; 95% CI 0.16 to 0.47), anxiety symptoms (mean diff.=0.34; 95% CI 0.17 to 0.52) and burn-out (mean diff.=0.54; 95% CI 0.36 to 0.71).ConclusionHCWs have experienced significant physical and psychological risk while working during the COVID-19 pandemic. These findings highlight the urgent need for increased support for provider physical and mental health well-being.
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Goodman, Jeremy, Samuel Clasp, Arjun Srinivasan, et al. "Shifting Landscape of Healthcare-Associated Infection and Antimicrobial Resistant Infection Reporting Policy, 2005–2019." Infection Control & Hospital Epidemiology 41, S1 (2020): s389. http://dx.doi.org/10.1017/ice.2020.1025.
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Background: Healthcare-associated infections (HAIs) are a serious threat to patient safety; they account for substantial morbidity, mortality, and healthcare costs. Healthcare practices, such as inappropriate use of antimicrobials, can also amplify the problem of antimicrobial resistance. Data collected to target HAI prevention and antimicrobial stewardship efforts and measure progress are an important resource for assuring transparency and accountability in healthcare, tracking adverse outcomes, investigating healthcare practices that may spread or protect against disease, detecting and responding to the spread of resistant pathogens, preventing infections, and saving lives. Methods: We discuss 3 healthcare-associated infection and antimicrobial Resistant infection (HAI-AR) reporting types: NHSN HAI-AR reporting, reportable diseases, and nationally notifiable diseases. HAI-AR reporting requirements outline facilities and data to report to NHSN and the health department to comply with state laws. Reportable diseases are those that facilities, providers, and laboratories are required to report to the health department. Nationally notifiable diseases are those reported by health departments to the CDC for nationwide surveillance and analysis as determined by Council of State and Territorial Epidemiologists (CSTE) and the CDC. Data presented are based on state and federal policy; NHSN data are based on CDC reporting statistics. Results: Since the 2005 launch of the CDC NHSN and publication of federal advisory committee HAI reporting guidance, most states have established policies stipulating healthcare facilities in their jurisdiction report HAIs and resistant infections to the NHSN to gain access to those data, increasing from 2 states in 2005, to 18 in 2010, and to 36 states, Washington, DC, and Philadelphia in 2019. Reporting policies and NHSN participation expanded greatly following the 2011 inception of CMS HAI quality reporting requirements, with several states aligning state requirements with CMS reporting. States listing carbapenem-resistant Enterobacteriaceae (CRE) as a reportable disease increased from 7 in 2013 to 41 states and the District of Columbia in 2019. Vancomycin-intermediate and vancomycin-resistant Staphylococcus aureus (VISA/VRSA) was added as a nationally notifiable disease in 2004, carbapenemase-producing CRE (CP-CRE) was added in 2018, and Candida auris clinical infections were added in 2019. The CDC and most jurisdictions with HAI reporting mandates issue public reports based on aggregate state data and/or facility-level data. States may also alert healthcare providers and health departments of emerging threats and to assist in notifying patients of potential exposure. Conclusions: Through efforts by health departments, facilities, patient advocates, partners, the CDC, and other federal agencies, HAI-AR reporting has steadily increased. Although reporting laws and data uses vary between jurisdictions, data provided serves as valuable tools to inform prevention.Funding: NoneDisclosures: None
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Castel, Amanda D., Manya Magnus, James Peterson, et al. "Implementing a Novel Citywide Rapid HIV Testing Campaign in Washington, D.C.: Findings and Lessons Learned." Public Health Reports 127, no. 4 (2012): 422–31. http://dx.doi.org/10.1177/003335491212700410.
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Objectives. In June 2006, the District of Columbia (DC) Department of Health launched a citywide rapid HIV screening campaign. Goals included raising HIV awareness, routinizing rapid HIV screening, identifying previously unrecognized infections, and linking positives to care. We describe findings from this seminal campaign and identify lessons learned. Methods. We applied a mixed-methods approach using quantitative analysis of client data forms (CDFs) and qualitative evaluation of focus groups with DC residents. We measured characteristics and factors associated with client demographics, test results, and community perceptions regarding the campaign. Results. Data were available on 38,586 participants tested from July 2006 to September 2007. Of those, 68% had previously tested for HIV (44% within the last 12 months) and 23% would not have sought testing had it not been offered. Overall, 662 (1.7%) participants screened positive on the OraQuick® Advance™ rapid HIV test, with non-Hispanic black people, transgenders, and first-time testers being significantly more likely to screen positive for HIV than white people, males, and those tested within the last year, respectively. Of those screening positive for HIV, 47% had documented referrals for HIV care and treatment services. Focus groups reported continued stigma regarding HIV and minimal community saturation of the campaign. Conclusions. This widespread campaign tested thousands of people and identified hundreds of HIV-infected individuals; however, referrals to care were lower than anticipated, and awareness of the campaign was limited. Lessons learned through this scale-up of population-based HIV screening resulted in establishing citywide HIV testing processes that laid the foundation for the implementation of test-and-treat activities in DC.
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Oda, Gina, Cynthia Lucero-Obusan, Patricia Schirmer, and Mark Holodniy. "1882. Tuberculosis in the Department of Veterans Affairs: Missed Opportunities for Prevention." Open Forum Infectious Diseases 6, Supplement_2 (2019): S50—S51. http://dx.doi.org/10.1093/ofid/ofz359.112.
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Abstract Background US and global elimination of tuberculosis (TB) is an important goal. Despite decreased incidence, CDC predicts elimination of TB in the US will not occur in the 21st century without improved detection and treatment of latent TB infection (LTBI). We describe the current burden of active TB infection and LTBI testing and treatment among patients within the Department of Veterans Affairs (VA). Methods Using the 2009 CDC case definition for laboratory-confirmed TB, we queried VA data sources from January 2010 to December 2018 for Mycobacterium tuberculosis detected via culture or nucleic acid amplification test (NAAT) from specimens from all body sites. For all TB patients, we extracted demographic, ICD-9 and ICD-10 risk factor, and LTBI testing and treatment data. Results Between 2010 and 2018, the average annual incidence of TB was 1.7 cases per 100,000 unique users of VA care (ranging from a high of 2.8 in 2010 to low of 0.8 in 2018). For 899 identified cases, demographic factors associated with highest TB rates were age between 45 and 64, Asian race, and residence in District of Columbia (Table 1). The most frequently occurring risk factors were substance abuse, diabetes, and homelessness. Of 90 patients with susceptibility documentation, 14 (15%) had resistance to 1 or more anti-TB drug (1 with multi-drug-resistant TB). Fifteen patients (1.7%) died within 7 days of their TB diagnosis; in all but 2 cases, TB was the primary cause of death (Table 2). Figure 1 depicts screening and treatment for LTBI among patients with TB. Only 228/899 (25.4%) TB patients had LTBI screening ≥ 3 months prior to diagnosis. Of the 347 TB patients never screened for LTBI, 264 (76%) had ≥ 1 documented TB risk factor. Among 228 patients screened for LTBI >3 months prior to active disease, 69 (30%) screened positive; however, only 24 (35%) had LTBI treatment initiated. Conclusion Although rates of TB infection are decreasing, VHA providers would benefit from education on recognizing patients with risk factors which place them at high risk for TB who should be screened for LTBI. CDC recommends preventive treatment of patients who screen positive for LTBI, and provider collaboration with local public health departments to provide directly observed therapy in cases where adherence may be in question. Disclosures All Authors: No reported Disclosures.
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Meyerson, Beth E., Alissa Davis, Hilary Reno, et al. "Existence, Distribution, and Characteristics of STD Clinics in the United States, 2017." Public Health Reports 134, no. 4 (2019): 371–78. http://dx.doi.org/10.1177/0033354919847733.
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Objectives: Studies of sexually transmitted disease (STD) clinics have been limited by the lack of a national list for representative sampling. We sought to establish the number, type, and distribution of STD clinics and describe selected community characteristics associated with them. Methods: We conducted a 2-phased, multilevel, online search from September 2014 through March 2015 and from May through October 2017 to identify STD clinics in all 50 US states and the District of Columbia. We obtained data on clinic name, address, contact information, and 340B funding status (which requires manufacturers to provide outpatient drugs at reduced prices). We classified clinics by type. We also obtained secondary county-level data to compare rates of chlamydia and HIV, teen births, uninsurance and unemployment, and high school graduation; ratios of primary care physician to population; health care costs; median household income; and percentage of population living in rural areas vs nonrural areas. We used t tests to examine mean differences in characteristics between counties with and without STD clinics. Results: We found 4079 STD clinics and classified them into 10 types; 2530 (62.0%) clinics were affiliated with a local health department. Of 3129 counties, 1098 (35.1%) did not have an STD clinic. Twelve states had an STD clinic in every county, and 34 states had ≥1 clinic per 100 000 population. Most STD clinics were located in areas of high chlamydia morbidity and where other surrogate needs were greatest; rural areas were underserved by STD clinics. Conclusions: This list may aid in more comprehensive national studies of clinic services, STD clinic adaptation to external policy changes (eg, in public financing or patient access policy), and long-term clinic survival, with special attention to clinic coverage in rural areas.
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Cáceres, Victor M., Jessica Goodell, Julie Shaffner, et al. "Centers for Disease Control and Prevention’s Temporary Epidemiology Field Assignee program: Supporting state and local preparedness in the wake of Ebola." SAGE Open Medicine 7 (January 2019): 205031211985072. http://dx.doi.org/10.1177/2050312119850726.
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Objectives: The Centers for Disease Control and Prevention launched the Temporary Epidemiology Field Assignee (TEFA) Program to help state and local jurisdictions respond to the risk of Ebola virus importation during the 2014–2016 Ebola Outbreak in West Africa. We describe steps taken to launch the 2-year program, its outcomes and lessons learned. Methods: State and local health departments submitted proposals for a TEFA to strengthen local capacity in four key public health preparedness areas: 1) epidemiology and surveillance, 2) health systems preparedness, 3) health communications, and 4) incident management. TEFAs and jurisdictions were selected through a competitive process. Descriptions of TEFA activities in their quarterly reports were reviewed to select illustrative examples for each preparedness area. Results: Eleven TEFAs began in the fall of 2015, assigned to 7 states, 2 cities, 1 county and the District of Columbia. TEFAs strengthened epidemiologic capacity, investigating routine and major outbreaks in addition to implementing event-based and syndromic surveillance systems. They supported improvements in health communications, strengthened healthcare coalitions, and enhanced collaboration between local epidemiology and emergency preparedness units. Several TEFAs deployed to United States territories for the 2016 Zika Outbreak response. Conclusion: TEFAs made important contributions to their jurisdictions’ preparedness. We believe the TEFA model can be a significant component of a national strategy for surging state and local capacity in future high-consequence events.
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Ossom-Williamson, Peace, Isaac Maximilian Williams, Kukhyoung Kim, and Tiffany B. Kindratt. "Reporting and Availability of COVID-19 Demographic Data by US Health Departments (April to October 2020): Observational Study." JMIR Public Health and Surveillance 7, no. 4 (2021): e24288. http://dx.doi.org/10.2196/24288.
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Background There is an urgent need for consistent collection of demographic data on COVID-19 morbidity and mortality and sharing it with the public in open and accessible ways. Due to the lack of consistency in data reporting during the initial spread of COVID-19, the Equitable Data Collection and Disclosure on COVID-19 Act was introduced into the Congress that mandates collection and reporting of demographic COVID-19 data on testing, treatments, and deaths by age, sex, race and ethnicity, primary language, socioeconomic status, disability, and county. To our knowledge, no studies have evaluated how COVID-19 demographic data have been collected before and after the introduction of this legislation. Objective This study aimed to evaluate differences in reporting and public availability of COVID-19 demographic data by US state health departments and Washington, District of Columbia (DC) before (pre-Act), immediately after (post-Act), and 6 months after (6-month follow-up) the introduction of the Equitable Data Collection and Disclosure on COVID-19 Act in the Congress on April 21, 2020. Methods We reviewed health department websites of all 50 US states and Washington, DC (N=51). We evaluated how each state reported age, sex, and race and ethnicity data for all confirmed COVID-19 cases and deaths and how they made this data available (ie, charts and tables only or combined with dashboards and machine-actionable downloadable formats) at the three timepoints. Results We found statistically significant increases in the number of health departments reporting age-specific data for COVID-19 cases (P=.045) and resulting deaths (P=.002), sex-specific data for COVID-19 deaths (P=.003), and race- and ethnicity-specific data for confirmed cases (P=.003) and deaths (P=.005) post-Act and at the 6-month follow-up (P<.05 for all). The largest increases were race and ethnicity state data for confirmed cases (pre-Act: 18/51, 35%; post-Act: 31/51, 61%; 6-month follow-up: 46/51, 90%) and deaths due to COVID-19 (pre-Act: 13/51, 25%; post-Act: 25/51, 49%; and 6-month follow-up: 39/51, 76%). Although more health departments reported race and ethnicity data based on federal requirements (P<.001), over half (29/51, 56.9%) still did not report all racial and ethnic groups as per the Office of Management and Budget guidelines (pre-Act: 5/51, 10%; post-Act: 21/51, 41%; and 6-month follow-up: 27/51, 53%). The number of health departments that made COVID-19 data available for download significantly increased from 7 to 23 (P<.001) from our initial data collection (April 2020) to the 6-month follow-up, (October 2020). Conclusions Although the increased demand for disaggregation has improved public reporting of demographics across health departments, an urgent need persists for the introduced legislation to be passed by the Congress for the US states to consistently collect and make characteristics of COVID-19 cases, deaths, and vaccinations available in order to allocate resources to mitigate disease spread.
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Landry, Matthew J., Kim Phan, Jared T. McGuirt, et al. "USDA Special Supplemental Nutrition Program for Women, Infants and Children (WIC) Vendor Criteria: An Examination of US Administrative Agency Variations." International Journal of Environmental Research and Public Health 18, no. 7 (2021): 3545. http://dx.doi.org/10.3390/ijerph18073545.
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The food retail environment has been directly linked to disparities in dietary behaviors and may in part explain racial and ethnic disparities in pregnancy-related deaths. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), administered by the United States Department of Agriculture, is associated with improved healthy food and beverage access due to its requirement for minimum stock of healthy foods and beverages in WIC-eligible stores. The selection and authorization criteria used to authorize WIC vendors varies widely from state to state with little known about the specific variations. This paper reviews and summarizes the differences across 16 of these criteria enacted by 89 WIC administrative agencies: the 50 states, the District of Columbia, five US Territories, and 33 Indian Tribal Organizations. Vendor selection and authorization criteria varied across WIC agencies without any consistent pattern. The wide variations in criteria and policies raise questions about the rational for inconsistency. Some of these variations, in combination, may result in reduced access to WIC-approved foods and beverages by WIC participants. For example, minimum square footage and/or number of cash register criteria may limit vendors to larger retail operations that are not typically located in high-risk, under-resourced communities where WIC vendors are most needed. Results highlight an opportunity to convene WIC stakeholders to review variations, their rationale, and implications thereof especially as this process could result in improved policies to ensure and improve healthy food and beverage access by WIC participants. More work remains to better understand the value of state WIC vendor authorization authority, particularly in states that have provided stronger monitoring requirements. This work might also examine if and how streamlining WIC vendor criteria (or at least certain components of them) across regional areas or across the country could provide an opportunity to advance interstate commerce and promote an equitable supply of food across the food system, while ensuring the protection for local, community-oriented WIC vendors.
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Brady, Kathleen A., Deborah S. Storm, Azita Naghdi, Toni Frederick, Jessica Fridge, and Mary Jo Hoyt. "Perinatal HIV Exposure Surveillance and Reporting in the United States, 2014." Public Health Reports 132, no. 1 (2016): 76–84. http://dx.doi.org/10.1177/0033354916681477.
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Objective: We sought to describe the current status of perinatal HIV exposure surveillance (PHES) activities and regulations in the United States and to make recommendations to strengthen PHES. Methods: In 2014, we sent an online survey to health departments in the 50 states, District of Columbia, Puerto Rico, Virgin Islands, and 6 cities and counties (Chicago, Illinois; Houston, Texas; Los Angeles, California; New York, New York; Philadelphia, Pennsylvania; and San Francisco, California). We analyzed responses from 56 of the 59 (95%) jurisdictions. Results: Thirty-three of 56 jurisdictions (59%) reported conducting PHES and following infants to determine their infection status. Of the 33 jurisdictions performing PHES, 28 (85%) linked maternal and infant data, but only 12 (36%) determined the HIV care status of postpartum women. Themes of respondents’ recommendations for strengthening PHES centered on updating laws and regulations to support PHES, reporting all HIV test results and linking vital records with PHES data to identify and follow HIV-exposed infants, communicating with health care providers to improve reporting, training staff, and getting help from experienced jurisdictions to implement PHES. Conclusions: Our findings indicate that data on perinatal exposure collected through the current system are inadequate to comprehensively monitor and prevent perinatal HIV exposure and transmission. Comprehensive PHES data collection and reporting are needed to sustain the progress that has been made toward lowering perinatal HIV transmission rates. We propose that minimum standards be established for perinatal HIV exposure reporting to improve the completeness, quality, and efficiency of PHES in the United States.
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Strodel, Rachel, Lauren Dayton, Henri M. Garrison-Desany, et al. "COVID-19 vaccine prioritization of incarcerated people relative to other vulnerable groups: An analysis of state plans." PLOS ONE 16, no. 6 (2021): e0253208. http://dx.doi.org/10.1371/journal.pone.0253208.
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Background Carceral facilities are epicenters of the COVID-19 pandemic, placing incarcerated people at an elevated risk of COVID-19 infection. Due to the initial limited availability of COVID-19 vaccines in the United States, all states have developed allocation plans that outline a phased distribution. This study uses document analysis to compare the relative prioritization of incarcerated people, correctional staff, and other groups at increased risk of COVID-19 infection and morbidity. Methods and findings We conducted a document analysis of the vaccine dissemination plans of all 50 US states and the District of Columbia using a triple-coding method. Documents included state COVID-19 vaccination plans and supplemental materials on vaccine prioritization from state health department websites as of December 31, 2020. We found that 22% of states prioritized incarcerated people in Phase 1, 29% of states in Phase 2, and 2% in Phase 3, while 47% of states did not explicitly specify in which phase people who are incarcerated will be eligible for vaccination. Incarcerated people were consistently not prioritized in Phase 1, while other vulnerable groups who shared similar environmental risk received this early prioritization. States’ plans prioritized in Phase 1: prison and jail workers (49%), law enforcement (63%), seniors (65+ years, 59%), and long-term care facility residents (100%). Conclusions This study demonstrates that states’ COVID-19 vaccine allocation plans do not prioritize incarcerated people and provide little to no guidance on vaccination protocols if they fall under other high-risk categories that receive earlier priority. Deprioritizing incarcerated people for vaccination misses a crucial opportunity for COVID-19 mitigation. It also raises ethical and equity concerns. As states move forward with their vaccine distribution, further work must be done to prioritize ethical allocation and distribution of COVID-19 vaccines to incarcerated people.
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Clemm, Hallie, and Erika Janifer. "District of Columbia Department of Public Works Street Sweeping Program Evaluation." Proceedings of the Water Environment Federation 2012, no. 5 (2012): 169–74. http://dx.doi.org/10.2175/193864712811699069.
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Billings, John, and Nina Teicholz. "Uninsured Patients in District of Columbia Hospitals." Health Affairs 9, no. 4 (1990): 158–65. http://dx.doi.org/10.1377/hlthaff.9.4.158.
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Nash, Marian. "Contemporary Practice of the United States Relating to International Law." American Journal of International Law 88, no. 2 (1994): 312–36. http://dx.doi.org/10.2307/2204103.
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By two circular notes, both dated December 22, 1993, the Secretary of State informed the Chiefs of Mission at Washington,,first, of recently enacted congressional legislation related to nonpayment of parking fines or penalties owed to the District of Columbia, and second, of a new policy with respect to payment of parking tickets, effective January 1, 1994, that the Department of State had initiated in response to congressional concerns about the problem and in cooperation with the District of Columbia.
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Uhrig Castonguay, Breana J., Andrew E. Cressman, Irene Kuo, et al. "The Implementation of a Text Messaging Intervention to Improve HIV Continuum of Care Outcomes Among Persons Recently Released From Correctional Facilities: Randomized Controlled Trial." JMIR mHealth and uHealth 8, no. 2 (2020): e16220. http://dx.doi.org/10.2196/16220.
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Background Previously incarcerated individuals have suboptimal linkage and engagement in community HIV care. Mobile health (mHealth) interventions have been shown to be effective in addressing these gaps. In Washington, District of Columbia (DC), we conducted a randomized trial of an SMS text messaging–based mHealth intervention (CARE+ Corrections) to increase linkage to community HIV care and antiretroviral treatment adherence among HIV-infected persons involved in the criminal justice system. Objective This study aimed to describe the SMS text messaging–based intervention, participant use of the intervention, and barriers and facilitators of implementation. Methods From August 2013 to April 2015, HIV-positive incarcerated individuals were recruited within the DC Department of Corrections, and persons released in the past 6 months were recruited within the community via street-based recruitment, community partnerships, and referrals. Participants were followed for 6 months and received weekly or daily SMS text messages. Formative research resulted in the development of the content of the messages in 4 categories: HIV Appointment Reminders, Medication Adherence, Prevention Reminders, and Barriers to Care following release from jail. Participants could customize the timing, frequency, and message content throughout the study period. Results Of the 112 participants enrolled, 57 (50.9%) were randomized to the intervention group and 55 (49.1%) to the control group; 2 control participants did not complete the baseline visit, and were dropped from the study, leaving a total of 110 participants who contributed to the analyses. Study retention was similar across both study arms. Median age was 42 years (IQR 30-50), 86% (49/57) were black or African American, 58% (33/57) were male, 25% (14/57) were female, and 18% (10/57) were transgender. Median length of last incarceration was 4 months (IQR 1.7-9.0), and median lifetime number of times incarcerated was 6.5 (IQR 3.5-14.0). Most participants (32/54, 59%) had a baseline viral load of <200 copies/mL. Nearly all participants (52/57, 91%) chose to use a cell phone provided by the study. The most preferred Appointment Reminder message was Hey how you feeling? Don’t forget to give a call and make your appointment (19/57, 33%). The most preferred Medication Adherence message was Don’t forget your skittles! (31/57, 54%), and 63% (36/57) of participants chose to receive daily (vs weekly) messages from this category at baseline. The most preferred Prevention Reminder message was Stay strong. Stay clean (18/57, 32%). The most preferred Barriers to Care message was Holla at your case manager, they’re here to help (12/57, 22%). Minor message preference differences were observed among participants enrolled in the jail versus those from the community. Conclusions Participants’ ability to customize their SMS text message plan proved helpful. Further large-scale research on mHealth platforms is needed to assess its efficacy among HIV-infected persons with a history of incarceration. Trial Registration ClinicalTrials.gov NCT01721226; https://clinicaltrials.gov/ct2/show/NCT01721226
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Giovachino, Monica, Thomas Calhoun, Neil Carey, et al. "Optimizing a District of Columbia Strategic National Stockpile Dispensing Center." Journal of Public Health Management and Practice 11, no. 4 (2005): 282–90. http://dx.doi.org/10.1097/00124784-200507000-00004.
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Pérez, Benito O. "Delineating and Justifying Performance Parking Zones." Transportation Research Record: Journal of the Transportation Research Board 2537, no. 1 (2015): 148–57. http://dx.doi.org/10.3141/2537-16.
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In the ongoing challenge to balance competing demands for curb space in dense urban areas, pricing has become an increasingly popular tool for better matching supply and demand. Performance parking, which applies variable pricing to parking, relies on performance metrics from responsive data and technology to manage pricing and occupancy or availability of parking. However, as parking managers and policy makers have embraced a more data-driven approach to price setting, they have not applied the same objectivity to the delineation of where performance parking should be implemented. The District of Columbia Department of Transportation is faced with the problem of where to apply performance parking appropriately. Initially, performance parking zones were legislatively designated, but in 2012, the enabling legislation was expanded to allow application citywide. Embracing the fact that performance parking is driven by objective metrics, the department developed a methodology to identify and define the objective efficacy of subareas to possibly implement performance parking. The background of the performance parking program is described and shows how the program goals were used to define several metrics for analyzing potential performance parking subareas. The analysis identified 10 potential subareas prime for implementation of performance-based curbside management pricing. This analysis provides an approach to establish the objective justification for the use of performance pricing within subareas of the District. As a result, the District of Columbia Department of Transportation can articulate why certain areas are selected and can implement performance parking with a higher level of confidence that the program will produce the intended impacts.
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Wepman, Noah. "Reforming the Power of the Purse: A Look at the Fiscal and Budgetary Relationship between the District of Columbia and the U.S. Congress." Policy Perspectives 9, no. 1 (2002): 22. http://dx.doi.org/10.4079/pp.v9i1.4229.
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The fiscal and budgetary relationship between the U.S. Congress and the District of Columbia is inconsistent with the typical federal governance system. In its current position, the District’s fiscal and budgetary authority is somewhere between that of a central city vis-a-vis its state capital and that of an Executive-level agency, like the Department of Commerce. The District is restricted in how it can raise revenue and formulate an annual budget, resulting in an often fragile fiscal environment. This article looks at the history of the current arrangement and suggests ways to reform the relationship between these two distinct government entities.
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Velezis, Marti James, Peter F. Sturm, and James Cobey. "Scoliosis Screening Revisited: Findings From the District of Columbia." Journal of Pediatric Orthopaedics 22, no. 6 (2002): 788–91. http://dx.doi.org/10.1097/01241398-200211000-00019.
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Salerno, April S., and Elena Andrei. "Inconsistencies in English Learner Identification: An Inventory of How Home Language Surveys Across U.S. States Screen Multilingual Students." AERA Open 7 (January 2021): 233285842110022. http://dx.doi.org/10.1177/23328584211002212.
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Home Language Surveys (HLS) are widely used by states as an initial screening tool to determine whether students should receive English as a Second Language (ESL) services. Parents/guardians are asked to complete the surveys when enrolling a student into a school. We collected surveys from the 50 states and the District of Columbia. We completed them as if we were the parent/guardian of six use-case students. Research questions were (1) How do HLS vary from state to state, if at all? What kinds of questions do they ask? (2) How do HLS across the 50 states and the District of Columbia identify, or not, six fictitious students for further ESL screening? We found that states and U.S. Department of Education–approved HLS questions identified students differently due to unclear questions, such as asking bilingual families to name one dominant language. We recommend additional validation measures be taken with survey questions.
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Teitelbaum, Joel, and Erica Spector. "District of Columbia v. Heller: Implications for Public Health Policy and Practice." Public Health Reports 124, no. 5 (2009): 758–60. http://dx.doi.org/10.1177/003335490912400519.
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Whyte, C. R. "Staffing a district psychotherapy service." Psychiatric Bulletin 13, no. 11 (1989): 596–98. http://dx.doi.org/10.1192/pb.13.11.596.
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Allen, Sean T., Monica S. Ruiz, and Jeff Jones. "Quantifying Syringe Exchange Program Operational Space in the District of Columbia." AIDS and Behavior 20, no. 12 (2016): 2933–40. http://dx.doi.org/10.1007/s10461-016-1405-y.
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Magnus, Manya, Gregory Phillips, Irene Kuo, et al. "HIV Among Women in the District of Columbia: An Evolving Epidemic?" AIDS and Behavior 18, S3 (2013): 256–65. http://dx.doi.org/10.1007/s10461-013-0514-0.
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Woods, J., K. Hollowed, A. Pavlovich, E. Lamb, and J. Shupp. "A collaborative program to reduce scald injury in The District of Columbia." Injury Prevention 16, Supplement 1 (2010): A131—A132. http://dx.doi.org/10.1136/ip.2010.029215.471.
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Brierley, Stephen, and David King. "An emergency department tackles bed management and home-based care." Australian Health Review 21, no. 4 (1998): 127. http://dx.doi.org/10.1071/ah980127.
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Ipswich Hospital Emergency Department played a vital role in the Post AcuteTreatment in the Home Program (PATH) of West Moreton District Health Service.PATH used two strategies to reduce the district reliance on acute hospital beds: a short-stayunit for rapid assessment, treatment and early discharge of patients with simpleconditions; and a hospital-in-the-home program utilising community health servicesto treat acute conditions.The program enhanced existing services to create a new treatment stream for acutepatients and to promote a cultural shift from fragmented care to district responsibilityfor total episode of patient care.
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Moni, Sudalai. "Health Care Services in Theni District - A Survey." Shanlax International Journal of Arts, Science and Humanities 8, no. 3 (2021): 114–18. http://dx.doi.org/10.34293/sijash.v8i3.3443.
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Theni District was carved out of erstwhile composite Madurai district on 01 January 1997 and ranked 28th in terms of the highest population in Tamil Nadu (around 12 ½ lakhs population). For providing necessary Health Care Services and facilities, the task was entrusted to the Public Health and Family Welfare Department. This establishment takes care of - primary health centers, child health services, maintains environmental sanitation and other vital services. Discussed in this paper certain key components such as Health Service Organization at the District level, Medical Department, Hospitals, Dispensaries, services rendered by organization and individuals, functions of primary health centers, family welfare programs, besides facilities in government hospitals, health checkup programs, counseling, and testing centers and other Health Care Services. The study indicates the necessity to enhance not only the quality of service but also to make it more accessible to the rural and tribal population of the Theni District in Tamil Nadu.
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Alghamdi, Khaled, Mark Zocchi, William J. Frohna, and Jesse M. Pines. "The 2013 Dip: Factors Influencing Falling Emergency Department Visits and Inpatient Admissions in District of Columbia and Maryland." Journal of Emergency Medicine 50, no. 6 (2016): 897–901. http://dx.doi.org/10.1016/j.jemermed.2016.02.028.
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Taggart, Virginia S., Patricia J. Bush, Alan E. Zuckerman, and Patricia K. Theiss. "A Process Evaluation of the District of Columbia “Know Your Body” Project." Journal of School Health 60, no. 2 (1990): 60–66. http://dx.doi.org/10.1111/j.1746-1561.1990.tb05907.x.
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Cottrell, A., E. Schwartz, R. Sokas, V. Kofie, and L. Welch. "Surveillance of sentinel occupational mortality in the District of Columbia: 1980 to 1987." American Journal of Public Health 82, no. 1 (1992): 117–19. http://dx.doi.org/10.2105/ajph.82.1.117.
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Mary, Evelyn Rose, S. Velusamy, U. Meena, and L. Lobithas. "Primary School Health Education: A Practical Project for a Small Hospital Community Health Department." Tropical Doctor 19, no. 2 (1989): 50–51. http://dx.doi.org/10.1177/004947558901900202.
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Lawrence, R. E., S. Cumella, and J. A. Robertson. "Patterns of Care in a District General Hospital Psychiatric Department." British Journal of Psychiatry 152, no. 2 (1988): 188–95. http://dx.doi.org/10.1192/bjp.152.2.188.
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A survey of all admissions of patients under the age of 65 during the first 6 years of a District General Psychiatric Department without mental-hospital support is reported. Three high-uptake groups of in-patients were defined; the long-stay (12 months or more), the medium-stay (6–12 months), and the revolving-door group (more than three admissions in any period of 12 months). Identifying characteristics which distinguish between these groups were examined. During a 7-year period there was no accumulation of long-stay patients, and a striking lack of schizophrenic patients who remained in hospital for more than 6 months or who had more than three admissions in any twelve-month period. This was not accounted for by drift of the high-uptake groups out of contact with the service, but may be related both to the style of service provision and to the socially cohesive nature of the area under study. Local variation should be given due importance when community services are being developed.
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Pérez, Benito O., Darren Buck, Yiwei Ma, Taylor Robey, and Kimberly Lucas. "Mind the Gap: Assessing the Impacts of Bicycle Accessibility and Mobility on Mode Share in Washington, D.C." Transportation Research Record: Journal of the Transportation Research Board 2662, no. 1 (2017): 83–92. http://dx.doi.org/10.3141/2662-10.
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The District of Columbia is enjoying rapid growth in cycling, evident through trends in census mode share data and in the presence of more cyclists out on the street. The District Department of Transportation (DOT) has spent significant resources in the past two decades to improve active transportation planning, outreach, and infrastructure delivery. These efforts have led to the District’s recognition as a cycling-friendly city. Now the District DOT is taking stock of what has been done to improve cycling thus far and to determine what to do next. The District DOT is starting to ask what is driving the growth in the cycling mode share. How can the District understand, nurture, and expand on that growth in the cycling mode share? This study explored underlying relationships in which the District’s cycling mode share was present. The analysis dug deeply by doing ( a) a statistical analysis to identify key factors that influenced cycling and ( b) a spatial analysis that defined trends in accessibility to cycling facilities and the mobility of the cycling network. Findings from this research will help inform District DOT planners on what policy, operational, outreach, and capital investment levers to consider as they continue to promote cycling in the District going forward.
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Jane Henley, S., Theodore C. Larson, Manxia Wu, et al. "Mesothelioma incidence in 50 states and the District of Columbia, United States, 2003–2008." International Journal of Occupational and Environmental Health 19, no. 1 (2013): 1–10. http://dx.doi.org/10.1179/2049396712y.0000000016.
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