Assessing Facility Readiness to Provide Equitable Birthing Care in New York State: A Baseline Survey.

Context: Facility policies, practices, and culture contribute to inequities in maternal outcomes. In New York State (NYS), Black birthing people are 4 to 5 times more likely to experience maternal mortality than White birthing people.

Objectives: Understanding the racial, ethnic, linguistic, and gender equity policies at NYS birthing facilities can identify areas of improvement to impact care and outcomes.

Social Media and Black Maternal Health: The Role of Health Literacy and eHealth Literacy.

Background: Black women experience greater maternal mortality and morbidity than White women. Although there are many causes of this disparity, providing more and better maternal health information to this population may be beneficial. Social media offers a way to easily and quickly disseminate information to empower and educate Black women about health during pregnancy.

Genomic Analysis of Vancomycin-Resistant Staphylococcus aureus Isolates from the 3rd Case Identified in the United States Reveals Chromosomal Integration of the Locus.

Vancomycin-resistant Staphylococcus aureus (VRSA) is a human pathogen of significant public health concern. Although the genome sequences of individual VRSA isolates have been published over the years, very little is known about the genetic changes of VRSA within a patient over time. A total of 11 VRSA, 3 vancomycin-resistant enterococci (VRE), and 4 methicillin-resistant S.

Maltreatment Related Hospitalizations Among Children Ages 17 Years and Younger: New York State, 2011-2013.

Background: Child maltreatment is an important societal and public health problem. However, there are limited data on the epidemiology of maltreatment related hospitalizations.

Objective: The objective of this study was to describe maltreatment related hospitalizations among children ages 17 and younger in New York State (NYS).

Statewide Initiative to Reduce Postnatal Growth Restriction among Infants <31 Weeks of Gestation.

Objective: To decrease the incidence of postnatal growth restriction, defined as discharge weight <10th percentile for postmenstrual age, among preterm infants cared for in New York State Regional Perinatal Centers.

Study Design: The quality improvement cohort consisted of infants <31 weeks of gestation admitted to a New York State Regional Perinatal Center within 48 hours of birth who survived to hospital discharge. Using quality improvement principles from the Institute for Healthcare Improvement and experience derived from successfully reducing central line-associated blood stream infections statewide, the New York State Perinatal Quality Collaborative sought to improve neonatal growth by adopting better nutritional practices identified through literature review and collaborative learning.

Severe maternal morbidity: A population-based study of an expanded measure and associated factors.

Severe maternal morbidity conditions such as sepsis, embolism and cardiac arrest during the delivery hospitalization period can lead to extended length of hospital stays, life-long maternal health problems, and high medical costs. Most importantly, these conditions also contribute to the risk of maternal death. This population-based observational study proposed and evaluated the impact of expanding the Centers for Disease Control and Prevention (CDC) measure of severe maternal morbidity by including additional comorbidities and intensive care admissions during delivery hospitalizations and examined associated factors.

A Community Needs Index for Adolescent Pregnancy Prevention Program Planning: Application of Spatial Generalized Linear Mixed Models.

Objective The objective is to estimate community needs with respect to risky adolescent sexual behavior in a way that is risk-adjusted for multiple community factors. Methods Generalized linear mixed modeling was applied for estimating teen pregnancy and sexually transmitted disease (STD) incidence by postal ZIP code in New York State, in a way that adjusts for other community covariables and residual spatial autocorrelation. A community needs index was then obtained by summing the risk-adjusted estimates of pregnancy and STD cases.

A Statewide Quality Improvement Initiative to Reduce Non-Medically Indicated Scheduled Deliveries.

Objectives To evaluate a large two-phase, statewide quality improvement (QI) collaborative to decrease non-medically indicated (N-MI) deliveries scheduled between 36 and 38 weeks gestation (early). Methods The New York State Department of Health (NYSDOH) convened a Perinatal Quality Collaborative to devise a two-phase QI initiative using a rapid cycle incremental learning model. Phase 1 included Regional Perinatal Centers (RPCs), and Phase 2 added their affiliated perinatal hospitals.

Variation in Enteral Feeding Practices and Growth Outcomes among Very Premature Infants: A Report from the New York State Perinatal Quality Collaborative.

Background: Extrauterine growth restriction (EUGR) is inversely related to neurodevelopmental outcome. We analyzed growth outcomes and enteral nutrition practices among preterm infants at New York State (NYS) regional perinatal centers (RPCs) to identify practices associated with risk of EUGR.

Methods: Surviving infants < 31 weeks' gestation admitted to a NYS RPC during 2010 were identified and data collected on their growth and enteral nutrition from a statewide database.

A multistate quality improvement program to decrease elective deliveries before 39 weeks of gestation.

Objective: Nonmedically indicated (elective) deliveries before 39 weeks of gestation result in unnecessary neonatal morbidity. We sought to determine whether implementation of a process improvement program will decrease the rate of elective scheduled singleton early-term deliveries (37 0/7-38 6/7 weeks of gestation) in a group of diverse community and academic hospitals.

Methods: Policies and procedures for scheduling inductions and cesarean deliveries were implemented and patient and health care provider education was provided.

Pediatric influenza-associated deaths in new york state: death certificate coding and comparison to laboratory-confirmed deaths.

Introduction. Surveillance for laboratory-confirmed influenza-associated deaths in children is used to monitor the severity of influenza at the population level and to inform influenza prevention and control policies. The goal of this study was to better estimate pediatric influenza mortality in New York state (NYS).

Low pathogenic avian influenza A (H7N2) virus infection in immunocompromised adult, New York, USA, 2003.

In 2003, infection with low pathogenic avian influenza A (H7N2) virus was identified in an immunocompromised man with fever and community-acquired pneumonia in New York, USA. The patient recovered. Although the source of the virus was not identified, this case indicates the usefulness of virus culture for detecting novel influenza A viruses.

Ready for our children? Results from a survey of upstate New York hospitals' utilization of Pediatric Emergency Preparedness Toolkit guidance.

Objective: This project evaluated New York (NY) hospitals outside of New York City (upstate) for their awareness and utilization of the NY State Department of Health Pediatric and Obstetric Emergency Preparedness Toolkit (toolkit) and presence of pediatric emergency preparedness planning elements.

Methods: A survey assessing toolkit awareness and utilization was distributed to all 145 upstate NY hospitals. Quantitative survey data were analyzed using summary statistics, χ(2) analysis, and odds ratios (OR) in aggregate, by hospital size, and by presence of pediatric medicine/surgery, pediatric intensive care unit (PICU), and/or neonatal ICU (NICU) beds (pediatric beds).

Breastfeeding practices in New York State maternity hospitals: results from a statewide survey.

Objective: This study characterized maternity hospital breastfeeding practices in New York.

Methods: The New York State Department of Health Breastfeeding Survey was sent to 138 hospitals providing maternity services to assess breastfeeding and rooming-in policies, infant feeding practices, breastfeeding training, staff structure, and support mechanisms. Additionally, hospital-specific exclusive breastfeeding rates were obtained from Hospital Profile data.

Assessing the health of migrant and seasonal farmworkers in New York State: statewide data 2003-2005.

Objectives: New York State data were used to document demographic characteristics and identify the top five most prevalent disease conditions among migrant and seasonal farmworkers and their families working in the state from 2003 to 2005.

Methods: Prevalence estimates were derived using enumeration and diagnosis data provided by New York State Department of Health contractors. The sample totals ranged from 6,500 to 8,000 migrant and seasonal farmworkers and their families.

Prevalence of and risk factors for hepatitis B and C infection among Mongolian blood donors.

Background: Mongolia has one of the highest rates of viral hepatitis infections worldwide yet risk factors have been largely unstudied. This sentinel study of hepatitis infection in Mongolia determined the prevalence of hepatitis B virus surface antigen (HBsAg) and hepatitis C virus antibody (anti-HCV) among a sample of blood donors and identified demographic and behavioral factors associated with hepatitis infection.

Study Design And Methods: Data were collected by interview from 923 Ministry of Health Blood Center donors between August 2004 and February 2005.

Agreement in self-reported personal risk factor information collected by different modes in Mongolia.

This study compares two methods (a self-administered paper survey and a face-to-face interview) of collecting information about personal risk behaviours important for studies of HIV and other blood-borne pathogen transmissions in a developing country. In the framework of an epidemiological study conducted among 2504 donors in the Blood Center at the Ministry of Health, Mongolia, 2250 participants completed a short paper survey and 923 participants were interviewed concerning risk factors for hepatitis infections. A total of 669 individuals completed both surveys.

Multistate outbreak of Pseudomonas fluorescens bloodstream infection after exposure to contaminated heparinized saline flush prepared by a compounding pharmacy.

Background: Pharmaceutical compounding, the manipulation of ingredients to create a customized medication, is a widespread practice. In January 2005, the Centers for Disease Control and Prevention was notified of 4 cases of Pseudomonas fluorescens bacteremia that were traced to contaminated heparinized saline intravenous flush syringes prepared as a compounded medical product.

Patients And Methods: We reviewed medical records of symptomatic patients with P.

A multistate outbreak of Serratia marcescens bloodstream infection associated with contaminated intravenous magnesium sulfate from a compounding pharmacy.

Background: In contrast to pharmaceutical manufacturers, compounding pharmacies adhere to different quality-control standards, which may increase the likelihood of undetected outbreaks. In 2005, the Centers for Disease Control and Prevention received reports of cases of Serratia marcescens bloodstream infection occurring in patients who underwent cardiac surgical procedures in Los Angeles, California, and in New Jersey. An investigation was initiated to determine whether there was a common underlying cause.

Community-associated methicillin-resistant Staphylococcus aureus skin infections in a religious community.

In September 2004, an outbreak of community-associated methicillin-resistant Staphylococcus aureus (MRSA) skin and soft tissue infections (SSTI) was reported among members of a religious community. We conducted a retrospective cohort study on all 175 community members; performed a nasal carriage survey, and environmental swab testing. We identified 24 MRSA cases (attack rate 14%).

Risk factors for cartilage infections of the ear.

Background: Investigation and case-control study to identify risk factors in a large outbreak in 2003 of auricular chondritis associated with piercing.

Methods: Epidemiologic, environmental, and laboratory (pulsed-field gel electrophoresis) investigation, and case-control study. Telephone interviews were conducted for 15 cases and 61 controls.

Hemolytic uremic syndrome incidence in New York.

A comparison of New York's traditional communicable disease surveillance system for diarrhea-associated hemolytic uremic syndrome with hospital discharge data showed a sensitivity of 65%. Escherichia coli O157:H7 was found in 63% of samples cultured from hemolytic uremic syndrome patients, and samples were more likely to be positive when collected early in illness.

The resistance and integrase genes of pACM1, a conjugative multiple-resistance plasmid, from Klebsiella oxytoca.

pACM1 is an 85-kb conjugative plasmid from a clinical isolate of Klebsiella oxytoca that encodes resistance to beta-lactams (mediated by SHV-5 extended spectrum beta-lactamase), trimethoprim, sulfonamides, tetracycline, aminoglycosides, and mercuric chloride. The expression of the aminoglycoside resistance is difficult to detect, which could have clinical implications. A region of pACM1 containing five resistance genes and two putative integrons was characterized by restriction mapping and partial DNA sequencing.

Molecular epidemiology of an SHV-5 extended-spectrum beta-lactamase in enterobacteriaceae isolated from infants in a neonatal intensive care unit.

Klebsiella oxytoca that produced extended-spectrum beta-lactamase (ESBL) and were resistant to ceftazidime were isolated from infants in a neonatal intensive care unit (NICU). During a 30-week period, 3 infants developed infections and an additional 60 infants were colonized with these bacteria. The molecular typing data suggested transmission of a single strain of ceftazidime-resistant K.

Cat scratch disease in two children presenting with fever of unknown origin: imaging features and association with a new causative agent, Rochalimaea henselae.

Objective: To report the clinical course, imaging findings, and method of diagnosis of two patients with systemic manifestations of cat scratch disease, presenting with fever of unknown origin.

Design: Case study.

Patients: Two children with fever of unknown origin who had multiple lesions in the liver and spleen, shown on ultrasound, computed tomography, and magnetic resonance imaging.