Comprehensive statewide approach to improve youth outcomes: experience of the New York State Youth Development Team.

Best practice research indicates a need for a policy shift toward positive youth development (YD) principles and strategies. The New York State Youth Development Team (YDT) is a public-private partnership of leading agencies whose holistic vision, "families, schools and communities partner to support the development of healthy, capable and caring youth," requires key stakeholders at all levels to address adverse youth health outcomes through effective partnerships. To transform the YDT vision into statewide practice requires committed actions (policy, funding, and training) at the state and community levels.

The potential role of an adult mentor in influencing high-risk behaviors in adolescents.

Background: While mentorship programs, which connect adolescents with adults to whom they can turn to for help and advice, are proliferating in an attempt to prevent high-risk behaviors in teenagers, there are few data to show that mentorship actually makes a difference.

Objective: To determine if there is an association between having an adult mentor and high-risk behaviors in adolescents.

Hypothesis: Adolescents who have an adult mentor would be less likely to engage in high-risk behaviors than those without an adult mentor.

Increased susceptibility to measles in infants in the United States.

Background: Women born in the United States after measles vaccine licensure in 1963 transfer less measles antibody to their infants than do older women. This may result in increased susceptibility to measles among infants.

Objective: To determine the effect of maternal year of birth on the risk for measles in infants.

Treatment of infants with reactive syphilis serology, New Jersey: 1992 to 1996.

Background And Rationale: Diagnosis of congenital syphilis is problematic: infants with congenital syphilis are often asymptomatic, and signs in symptomatic infants are frequently subtle and nonspecific. Furthermore, there are no readily available diagnostic tests that provide a definitive diagnosis. Previously, the diagnosis of congenital syphilis was based on a complex set of clinical and laboratory criteria, and only infants with clinically apparent illness or laboratory findings indicating congenital syphilis were classified as cases and reported to health departments and the Centers for Disease Control and Prevention (CDC).

Emergence of Lyme disease in Hunterdon County, New Jersey, 1993: a case-control study of risk factors and evaluation of reporting patterns.

Reported cases of Lyme disease in Hunterdon County, New Jersey, increased almost 200% from 75 (67/100,000 population) in 1992 to 216 (193/100,000 population) in 1993. For evaluation of risk factors for Lyme disease and for determination of the cause of this increase, a case-control study was conducted, and the reporting practices of physicians' offices were evaluated. For cases reported in 1993, age and sex distribution, month of disease onset, and proportion of cases with erythema migrans rash were within expected limits.

Mycobacterium tuberculosis transmission from a pediatrician to patients.

Unlabelled: The following report describes the contact investigation of a pediatrician with tuberculosis (TB). The pediatrician's disease was discovered in late February 1993 after tuberculin skin testing (TST) of his 15-month-old son was positive (13-mm induration). Further investigation to identify the source of the child's infection revealed a positive (15-mm induration) TST in the pediatrician.

Learning to design new systems: communicable disease surveillance.

The basis for public health actions and its supporting information systems are being questioned. Problems with the New Jersey communicable disease surveillance system were examined. Inability to discriminate unusual disease patterns was disclosed.

Risk factors for sporadic infection with Escherichia coli O157:H7.

Background: Little is known about risk factors for sporadic infection with Escherichia coli O157:H7. In response to a sharp increase in reported cases in New Jersey during July 1994, we conducted a case-control study to identify principal sources of infection and contributing practices.

Methods: Standardized questionnaires were used to evaluate (1) potential exposures of case patients and matched controls and (2) knowledge, attitudes, and practices of food preparers in case and control households.

Selective screening versus presumptive treatment criteria for identification of women with chlamydial infection in public clinics: New Jersey.

Objective: Our goals were to determine the prevalence of chlamydial infection, to identify criteria for selective screening, and to compare the sensitivity of selective screening to presumptive treatment criteria in different clinical settings.

Study Design: A total of 5128 women enrolled in a cross-sectional study in public clinics in New Jersey. Univariate and multivariate methods of statistical analysis were used.

Beliefs and practices regarding childhood vaccination among urban pediatric providers in New Jersey.

Background: In 1991, the fourth largest measles outbreak in the nation (824 cases) occurred in the Jersey City, New Jersey area. Data from a subsequent intervention trial in Jersey City demonstrated that vaccinations were more likely to be delayed for children who had received care from private rather than public clinic providers. In addition, failure to administer multiple indicated vaccines at a single visit was associated with vaccination delay, and reluctance to administer multiple vaccines was more common among private providers.

A statewide surveillance system for antimicrobial-resistant bacteria: New Jersey.

Objectives: To determine the validity of an active, hospital laboratory isolate-based surveillance system in estimating rates of infection and to evaluate the use of surveillance data in describing institutional risk factors for increased rates of infection. Methicillin-resistant Staphylococcus aureus (MRSA) was chosen as the prototype organism for these evaluations.

Design: Correlation Study: linear regression analysis and Student's t test were used to evaluate the correlation between number of MRSA isolates and number of MRSA infections in acute-care hospitals.

Biliary complications in the treatment of unsubstantiated Lyme disease.

Treatment of unsubstantiated Lyme disease has led to serious complications in some cases. Two case-control studies, based on information in clinical records of patients discharged with a diagnosis of Lyme disease during 1990-1992, were conducted at a central New Jersey hospital. Twenty-five patients with biliary disease were identified, and 52 controls were selected from 1352 patients with suspected Lyme disease.

Hemolytic uremic syndrome in New Jersey.

In an 18-month study period, the authors identified 23 cases of hemolytic uremic syndrome (HUS) in New Jersey children. Increased identification and reporting of Escherichia coli O157:H7 are needed to prevent additional morbidity and mortality.

Boilerbaisse: an outbreak of methemoglobinemia in New Jersey in 1992.

Background: On October 20, 1992, > 40 children from one elementary school visited the school nurse due to the acute onset of blue lips and hands, vomiting, and headache during and after the school lunch periods. Forty-nine children were seen by physicians that day and 14 were hospitalized. Laboratory analysis revealed methemoglobinemia in many of the children.

Ability of clinical laboratories to detect antimicrobial agent-resistant enterococci.

To test the ability of clinical laboratories to detect antimicrobial resistance among enterococci, we sent four vancomycin-resistant enterococcal strains and one beta-lactamase-producing enterococcus to all 93 nongovernment, hospital-based clinical laboratories in New Jersey; 76 (82%) participated in the study. Each organism was tested by the laboratory's routine antimicrobial susceptibility testing method. The proportion of laboratories that correctly reported that an isolate was resistant to vancomycin varied according to the resistance level of the isolate: high-level resistance (MIC for Enterococcus faecium = 512 micrograms/ml), 96% of laboratories correct; moderate-level resistance (MIC for E.

Early syphilis. Relationship to sex, drugs, and changes in high-risk behavior from 1987-1990.

A case-control study was conducted to evaluate two main questions: 1) which specific sex- and drug-use behaviors are associated with the acquisition of early syphilis; and 2) whether changes in sex- and drug-use behaviors from 1987-1990 associated with acquisition of early syphilis. Risk factors associated with significant odds ratio were greater than four sex partners and lack of condom use in the past 3 months. Crack use within the past 3 months was the only specific drug-related risk factor with a significantly elevated odds ratio.

Outbreak of cholera associated with crab brought from an area with epidemic disease.

From 31 March through 3 April 1991, 8 New Jersey residents developed severe, watery diarrhea after eating crabmeat brought back in the suitcase of a traveler to Ecuador. Stool cultures yielded toxigenic Vibrio cholerae O1, serotype Inaba, biotype El Tor from 4 persons, and vibriocidal antibody titers were > or = 1:640 in 7 persons, indicating recent infection with Vibrio cholerae O1. Eating crab was statistically associated with illness (P = .

Postoperative group A beta-hemolytic Streptococcus outbreak with the pathogen traced to a member of a healthcare worker's household.

A cluster of four group A beta-hemolytic Streptococcus postoperative wound infections was investigated at a community hospital. The serotypes of the Streptococcus isolated from all four cases, an asymptomatic anesthesiologist and one of his household members were M nontypable T28. During the outbreak period, December 1988, the infection rate among the 40 patients of the anesthesiologist was 7.

Epidemiology of congenital syphilis.

Between 1984 and 1987, the number of reported cases of congenital syphilis in New Jersey tripled. Findings indicate an increase in early syphilis among females of childbearing age living in areas of high syphilis morbidity, reflecting, possibly, lifestyle changes within populations already at risk for the disease. Future studies and interventions are needed.

Risk factors for infection with plasmid-mediated high-level tetracycline resistant Neisseria gonorrhoeae.

This study was done to determine whether the increase in high-level tetracycline resistant Neisseria gonorrhoeae (TRNG) was associated with increased tetracycline use. From 547 persons with positive cultures seen consecutively at a sexually transmitted disease (STD) clinic, 51 (9%) isolates were resistant to tetracycline. Of these 51 isolates, 37 (73%) had high-level resistance (TRNG) which was mediated by the tetM determinant located on a 25.

Pontiac fever outbreak associated with a cooling tower.

In late April 1984, an outbreak of Pontiac fever was investigated in an office building in lower Manhattan (New York City). The outbreak was characterized by a high attack rate (78 per cent overall); the predominant symptoms were myalgias, chills, fatigue, fever, and headache. There was a clustering of cases in an office that was air cooled by a dedicated cooling tower separate from the remainder of the building.

Foodborne Snow Mountain agent gastroenteritis in a school cafeteria.

In 1984, an outbreak of gastroenteritis occurred at a school with 1,860 students in Brooklyn, NY. In a single-stage cluster sample of 375 students, 129 (34%) had illnesses that met our case definition of vomiting or diarrhea. The mean incubation period was 26 hours, and the mean illness duration was 24 hours.