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Joan A Reid, Tara N Richards, Thomas A Loughran, Edward P Mulvey
Background: Gun violence and psychological problems are often conflated in public discourse on gun safety. However, few studies have empirically assessed the effect of exposure to violence when exploring the association between gun carrying and psychological distress. Objective: To examine the potential effect of exposure to violence on the associations between gun carrying and psychological distress among vulnerable adolescents. Design: Longitudinal cohort study...
March 21, 2017: Annals of Internal Medicine
Julie M Fleischman, Ashley E Kendell, Christen C Eggers, Laura C Fulginiti
Undocumented Border Crosser (UBC) deaths in Arizona are a major issue faced by medicolegal authorities. Currently, the Maricopa County Office of the Medical Examiner (MCOME) is in possession of over two hundred unidentified individuals, more than half of whom are presumed to be UBCs. The primary goal of this study was to address the growing number of UBC deaths in Maricopa County in order to provide a more comprehensive picture of this important anthropological issue within the state of Arizona. Of the 107 total UBC cases evaluated for the study, the majority were male and age estimates for all individuals were between 15 to 60 years old...
January 9, 2017: Journal of Forensic Sciences
Kristl Tomlin, Tammalynn Bambulas, Maureen Sutton, Vanessa Pazdernik, Dean V Coonrod
STUDY OBJECTIVE: To determine if teenage patients receiving prenatal care in an adolescent-focused clinic, emphasizing long-acting reversible contraception (LARC) using motivational interviewing techniques, had higher rates of uptake of postpartum LARC than a control group. DESIGN AND SETTING: Retrospective cohort study comparing young women who received prenatal care in an adolescent-focused setting with those enrolled in standard prenatal care. PARTICIPANTS: Adolescents between the ages of 13 and 17 years receiving prenatal care within the Maricopa Integrated Health safety-net system between 2007 and 2014...
November 18, 2016: Journal of Pediatric and Adolescent Gynecology
P Grady Dixon, Adam J Kalkstein
There has been much research on the associations between weather variables and suicide rates. However, the state of understanding has remained rather stagnant due to many contradictory findings. The purpose of this project is to examine a larger database of suicides that includes a longer and more recent period of record (1975-2010) across numerous locations in the USA. In all, we examine nine total counties (and the primary city associated with them) with a special effort made to compare locations with varying degrees of temperature seasonality: Cook (Chicago), Fulton (Atlanta), King (Seattle), Los Angeles (Los Angeles), Maricopa (Phoenix), Miami-Dade (Miami), Philadelphia (Philadelphia), Salt Lake (Salt Lake City), and St...
November 7, 2016: International Journal of Biometeorology
Vijay Christopher Kannan, Nicole Hodgson, Andrew Lau, Kate Goodin, Andrea Freyer Dugas, Frank LoVecchio
STUDY OBJECTIVE: We seek to use a novel layered-surveillance approach to localize influenza clusters within an acute care population. The first layer of this system is a syndromic surveillance screen to guide rapid polymerase chain reaction testing. The second layer is geolocalization and cluster analysis of these patients. We posit that any identified clusters could represent at-risk populations who could serve as high-yield targets for preventive medical interventions. METHODS: This was a prospective observational surveillance study...
November 2016: Annals of Emergency Medicine
David P Eisenman, Holly Wilhalme, Chi-Hong Tseng, Mikhail Chester, Paul English, Stephanie Pincetl, Andrew Fraser, Sitaram Vangala, Satvinder K Dhaliwal
In an extreme heat event, people can go to air-conditioned public facilities if residential air-conditioning is not available. Residences that heat slowly may also mitigate health effects, particularly in neighborhoods with social vulnerability. We explored the contributions of social vulnerability and these infrastructures to heat mortality in Maricopa County and whether these relationships are sensitive to temperature. Using Poisson regression modeling with heat-related mortality as the outcome, we assessed the interaction of increasing temperature with social vulnerability, access to publicly available air conditioned space, home air conditioning and the thermal properties of residences...
September 2016: Health & Place
April J Cobos, Clinton G Nelson, Megan Jehn, Cécile Viboud, Gerardo Chowell
BACKGROUND: While prior studies have quantified the mortality burden of the 1957 H2N2 influenza pandemic at broad geographic regions in the United States, little is known about the pandemic impact at a local level. Here we focus on analyzing the transmissibility and mortality burden of this pandemic in Arizona, a setting where the dry climate was promoted as reducing respiratory illness transmission yet tuberculosis prevalence was high. METHODS: Using archival death certificates from 1954 to 1961, we quantified the age-specific seasonal patterns, excess-mortality rates, and transmissibility patterns of the 1957 H2N2 pandemic in Maricopa County, Arizona...
2016: BMC Infectious Diseases
J Mac McCullough, Eileen Eisen-Cohen, S Bianca Salas
BACKGROUND: Many health departments collaborate with community organizations on community health improvement processes. While a number of resources exist to plan and implement a community health improvement plan (CHIP), little empirical evidence exists on how to leverage and expand partnerships when implementing a CHIP. The purpose of this study was to identify characteristics of the network involved in implementing the CHIP in one large community. The aims of this analysis are to: 1) identify essential network partners (and thereby highlight potential network gaps), 2) gauge current levels of partner involvement, 3) understand and effectively leverage network resources, and 4) enable a data-driven approach for future collaborative network improvements...
2016: BMC Public Health
Richard J Caselli, Amylou C Dueck, Dona E C Locke, Bruce R Henslin, Travis A Johnson, Bryan K Woodruff, Charlene Hoffman-Snyder, Yonas E Geda
OBJECTIVES: The aim of this study was to assess the association between personality factors and age-related longitudinal cognitive performance, and explore interactions of stress-proneness with apolipoprotein E (APOE) ɛ4, a prevalent risk factor for Alzheimer's disease (AD). METHODS: A total of 510 neuropsychiatrically healthy residents of Maricopa County recruited through media ads (mean age 57.6±10.6 years; 70% women; mean education 15.8±2.4 years; 213 APOE ɛ4 carriers) had neuropsychological testing every 2 years (mean duration follow-up 9...
August 2016: Journal of the International Neuropsychological Society: JINS
Aurimar Ayala, Vjollca Berisha, Kate Goodin, Kristen Pogreba-Brown, Craig Levy, Benita McKinney, Lia Koski, Sara Imholte
Super Bowl XLIX took place on February 1, 2015, in Glendale, Arizona. In preparation for this event and associated activities, the Maricopa County Department of Public Health (MCDPH) developed methods for enhanced surveillance, situational awareness, and early detection of public health emergencies. Surveillance strategies implemented from January 22 to February 6, 2015, included enhanced surveillance alerts; animal disease surveillance; review of NFL clinic visits; syndromic surveillance for emergency room visits, urgent care facilities, and hotels; real-time onsite syndromic surveillance; all-hazards mortality surveillance; emergency medical services surveillance, review of poison control center reports; media surveillance; and aberration detection algorithms for notifiable diseases...
May 2016: Health Security
Ahmed Mohamed, Kate Goodin, Ronald Pope, Mark Hubbard, Michael Levine
The objective of this study was to evaluate the association of asthma hospital visits with ozone concentrations in Maricopa County, Arizona. We used time plots and distributed lag nonlinear models to achieve these objectives while accounting for some potential confounders including temperature and day of the week. A total of 90,381 asthma hospitalizations were retrieved from the dataset (daily median = 39, range: 8-122). Asthma hospitalizations were highest in 2008 (16,949), during the months of November through December, and lowest in 2011 (13,213), during the months of June through July...
May 2016: Journal of Environmental Health
Joe Robert Mireles, Roxanne Ereth, Tom Mickey, Richard May, Melanie M Taylor
BACKGROUND: Increasing numbers of reported primary and secondary (P&S) syphilis cases in the United States suggest the need for improved surveillance methods. An outbreak detection method using reported syphilis test results, which can be counted before the conclusion of a syphilis case investigation, could lead to timelier outbreak detection. METHODS: The historical limits comparison method was used to compare the number of positive rapid plasma reagin results reported during 2011-2014 with data for the preceding 3 years...
June 2016: Sexually Transmitted Diseases
J Mac McCullough
OBJECTIVES: A major responsibility of a local health department (LHD) is to assure public health service availability throughout its jurisdiction. Many LHDs face expanded service needs and declining budgets, making billing for services an increasingly important strategy for sustaining public health service provision. Yet, little practice-based data exist to guide practitioners on what to expect financially, especially regarding timing of reimbursement receipt. This study provides results from one LHD on the lag from service delivery to reimbursement receipt...
March 2016: Public Health Reports
Thomas A Loughran, Joan A Reid, Megan Eileen Collins, Edward P Mulvey
OBJECTIVES: We observed how perceptions of risks, costs, crime rewards, and violence exposure change as individual gun-carrying behavior changes among high-risk adolescents. METHODS: We analyzed a longitudinal study (2000-2010) of serious juvenile offenders in Maricopa County, Arizona, or Philadelphia County, Pennsylvania, assessing within-person changes in risk and reward perceptions, and violence exposure as individuals initiated or ceased gun carrying. RESULTS: Despite being associated with heightened exposure to violence, gun carrying was linked to lower perceptions of risks and costs and higher perceived rewards of offending...
February 2016: American Journal of Public Health
Candice L Robinson, Lauren Young, Kristine Bisgard, Tom Mickey, Melanie M Taylor
Delays in syphilis treatment may contribute to transmission. We evaluated time to treatment for symptomatic patients with syphilis by clinical testing site in 2 Arizona counties. Fewer patients were tested and treated at publicly funded sexually transmitted disease clinics, but received the timeliest treatment; these clinics remain crucial to syphilis disease control.
January 2016: Sexually Transmitted Diseases
Christina A Cutshaw, Steffie Woolhandler, David U Himmelstein, Christopher Robertson
The objective of this study was to elucidate the medical causes and consequences of foreclosure. We surveyed 90 households undergoing foreclosure in 2013-2014 in Maricopa County, Arizona on two occasions approximately five months apart. At baseline, median monthly household income was $3,000, and median mortgage payment $1,350. Only 10% of respondents lacked health insurance when surveyed, although 28% had experienced a gap in coverage within the past two years. Fifty-seven percent identified a medical debt or another medical cause of their foreclosure, and 54% had taken on new debt to pay medical bills; 10% had mortgaged their home for this reason...
2016: International Journal of Health Services: Planning, Administration, Evaluation
John A Hnida
Isospora gopheri n. sp. (Apicomplexa: Eimeriidae) is described from 5 of 28 (18%) Morafka's desert tortoise Gopherus morafkai Murphy, Berry, Edwards, Leviton, Lathrop & Readle, housed by the Phoenix Herpetological Society, Maricopa County, Arizona, USA. Sporulated oöcysts of this new species were spheroidal to subspheroidal, 20-27 × 19-27 (23.0 × 21.7) µm, with a smooth, bi-layered wall and 1-3 polar granules; an oöcyst residuum was absent. Sporocysts were elongate-ovoidal to ellipsoidal, 13-18 × 9-12 (15...
November 2015: Systematic Parasitology
Amanda J Witsil, Raegan J Wells, Craig Woods, Sangeeta Rao
Medical records of 272 rattlesnake envenomations of canines from 5 veterinary emergency centers in Maricopa County, Arizona between 2010 and 2012 were investigated. The objectives were to examine the patient demographics, severity of clinical signs, and treatment modalities employed, in order to discuss the outcomes of certain therapies including glucocorticoid use, antibiotic use, rattlesnake vaccination, and safety of antivenom administration in dogs. Evaluation was performed to model each response (survival, proposed canine snakebite severity score (cSSS), and length of stay) as a function of multiple variables...
October 2015: Toxicon: Official Journal of the International Society on Toxinology
Robert McGuire, Eric Moore
Given the clinical and public health benefits of routine Human Immunodeficiency Virus (HIV) testing in the emergency department (ED) and Centers for Disease Control and Prevention recommendations, Maricopa Medical Center, as part of Maricopa Integrated Health System, started Test, Educate, Support, and Treat Arizona (TESTAZ) and became the first and, to-date, only hospital in Arizona to implement routine, non-targeted, opt-out, rapid HIV screening in the ED. The authors describe the implementation of a universal, routine, opt-out HIV screening program in the adult ED of an urban safety-net hospital serving under-served populations, including the uninsured and under-insured...
March 2016: Journal of the American Medical Informatics Association: JAMIA
Beatrix Dudzik, Natalie R Langley
The os pubis is one of the most widely used areas of the skeleton for age estimation. Current pubic symphyseal aging methods for adults combine the morphology associated with the developmental changes that occur into the mid-30s with the degenerative changes that span the latter portion of the age spectrum. The most popular methods are phase-based; however, the definitions currently used to estimate age intervals may not be adequately defined and/or accurately understood by burgeoning researchers and seasoned practitioners alike...
December 2015: Forensic Science International
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