Development and Evaluation of Surveillance System for Identifying Jail-Associated COVID-19 Cases in Minnesota, USA, 2022.

Confinement facilities are high-risk settings for the spread of infectious disease, necessitating timely surveillance to inform public health action. To identify jail-associated COVID-19 cases from electronic laboratory reports maintained in the Minnesota Electronic Disease Surveillance System (MEDSS), Minnesota, USA, the Minnesota Department of Health developed a surveillance system that used keyword and address matching (KAM). The KAM system used a SAS program (SAS Institute Inc., https://www.sas.com) and an automated program within MEDSS to identify confinement keywords and addresses. To evaluate KAM, we matched jail booking data from the Minnesota Statewide Supervision System by full name and birthdate to the MEDSS records of adults with COVID-19 for 2022. The KAM system identified 2,212 cases in persons detained in jail; sensitivity was 92.40% and specificity was 99.95%. The success of KAM demonstrates its potential to be applied to other diseases and congregate-living settings for real-time surveillance without added reporting burden.

Differences in mobile food market customer outcomes between 2019 and 2021.

OBJECTIVES: To evaluate the outcomes of increasing mobile market service from mostly biweekly in 2019 to weekly in 2021. DESIGN: Repeated, cross-sectional customer intercept surveys. SAMPLE: Mobile market customers in Summers 2019 (N = 302) and 2021 (N = 72). INTERVENTION: Mobile food markets bring affordable, high-quality foods to communities that lack such access. MEASURES/ANALYSIS: Outcomes included food security, fruit/vegetable intake, and food-related characteristics and behaviors. General linear and logistic regression models were used to assess associations between outcomes and survey year and length of mobile market shopping. Models were adjusted for economic assistance use, race, and ethnicity. RESULTS: No outcomes were significantly different between 2019 (with mostly biweekly service) and 2021 (with weekly service). Length of mobile market shopping (e.g., >2 years, 1-2 years, etc.) was positively associated with affordable, quality food access (ß = 0.20, SE = 0.10, p = .03) and fruit/vegetable intake (ß = 0.28, SE = 0.08, p < .001) as well as lower odds of food insecurity in the last 12 months (aOR = 0.79, 95% CI = 0.64, 0.99). CONCLUSIONS: Despite COVID-19 interrupting scheduled market service, the length of time that a survey respondent identified as a full-service mobile market customer was associated with higher food access and fruit/vegetable intake and reduced food insecurity odds. These findings suggest promise and encourage further evaluation.

Food insecurity, food-related characteristics and behaviors, and fruit and vegetable intake in mobile market customers.

Mobile markets (MM) bring affordable, quality, healthy foods to high-need, low-food access communities. However, little is known about food insecurity of MM customers. This manuscript evaluates food insecurity prevalence in MM customers and assesses associations between food insecurity and MM use, food-related characteristics and behaviors, and fruit and vegetable (FV) intake. Customers (N = 302) completed cross-sectional surveys in summer 2019 that assessed: food security, food availability, cooking attitude, self-efficacy for healthy cooking, self-efficacy for cooking and eating FV, social connectedness, and FV intake. Descriptive and multivariate analyses were used to describe and assess associations with food insecurity and FV intake. Results show most MM customers were food insecure (85%). In logistic regression models adjusted for sociodemographic characteristics, long-term MM use (OR = 0.77, CI = 0.60-0.997), access to affordable, quality foods (OR = 0.81, CI = 0.71-0.93), and self-efficacy for both cooking healthy foods (OR = 0.88, CI = 0.80-0.97) and cooking and eating FV (OR = 0.90, CI = 0.82-0.98) were associated with lower odds of food insecurity; negative cooking attitudes (OR = 1.12, CI = 1.02-1.24) were associated with higher odds of food insecurity. Being food insecure (ß = -1.37, SE=0.43, p < 0.01) was associated with poorer FV intake; this association attenuated slightly (ß = -1.22, SE=0.43, p < 0.01) when length of MM use was added to the general linear model, which was also associated with higher fruit and vegetable intake (ß = 0.26, SE=0.10, p = 0.01). Results suggest the MM reaches customers experiencing high levels of food insecurity and long-term MM use is associated with lower food insecurity and higher FV intake. Relationships between food insecurity and several food characteristics/behaviors provide insight for potential targets for wrap-around interventions to address food insecurity among customers. Findings suggest longitudinal evaluation of the MM's impact on food security and other food-related characteristics/behaviors is warranted.

Estimates of on-farm antimicrobial usage in broiler chicken production in the United States, 2013-2017.

Antimicrobial use is a key selective force behind the emergence of resistant bacteria. Therefore, optimizing strategies for more efficacious and targeted antimicrobial use is an essential component of efforts to combat antimicrobial resistance. To bolster stewardship programmes in animal agriculture, processes are needed for the systematic collection of on-farm antimicrobial use data. The objective of this study was to develop a system for collecting on-farm antimicrobial use data from the US broiler industry and to have it be representative of the largest commercial broiler producers in the United States that comprise the vast majority of national broiler production. Participation was voluntary. Data were collected for the period 2013 through 2017 and are reported on a calendar year basis. Using statistics from USDA:NASS as a denominator, the data supplied by participating companies accounted for approximately 81.7% of broiler production in the United States in 2013 and increased to approximately 87.2% in 2017. The data that were submitted for 2017 are based on approximately 7,897,339,357 chicks placed, 7,541,449,430 chickens slaughtered and 48,225,124,865 pounds liveweight produced. The use of antimicrobials in the hatchery decreased substantially between 2013 and 2017; the approximate percentage of broiler chicks placed that received hatchery antimicrobials decreased from 93% in 2013 to 17% in 2017. Medically important in-feed antimicrobial use decreased substantially. For example, in-feed tetracycline use decreased approximately 95% between 2013 and 2017. Medically important water-soluble antimicrobial use decreased substantially for most antimicrobials. Between 2013 and 2017, water-soluble penicillin use decreased approximately 21%, water-soluble tetracycline use decreased approximately 47%, and water-soluble lincomycin use decreased approximately 28%. While a reduction in antimicrobial amounts used may be an important indicator of improved stewardship, reducing the need for antimicrobials through improved disease prevention should be considered a more important objective and a better indicator of overall flock health and optimal antimicrobial use.

Estimates of on-farm antimicrobial usage in turkey production in the United States, 2013-2017.

With increasing concern about the emergence and spread of resistant bacteria, there is an increasing motivation to optimize antimicrobial use administrations in animal agriculture. A key component of antimicrobial stewardship is the ability to collect antimicrobial use data and ultimately use this information to assess that administrations are necessary and effective. The objective of this study was to develop a system for collecting on-farm antimicrobial use data from the US turkey industry and to have it be representative of the largest commercial turkey producers in the United States that comprise the vast majority of national turkey production. Participation was voluntary. Data were collected for the period 2013 through 2017 and are reported on a calendar year basis. Using statistics from USDA:NASS as a denominator, the data supplied by participating companies represented approximately 67.3% of turkey production in the United States in 2013 and increased to approximately 69.8% in 2017. The data that were submitted for 2017 are based on approximately 187,016,604 poults placed, 164,081,335 turkeys slaughtered, and 5,178,431,422 pounds liveweight produced. The estimated percentage of turkey poults placed that received hatchery antimicrobials decreased from 96% in 2013 to 41% in 2017. Medically important in-feed antimicrobial use decreased substantially. For example, in-feed tetracycline use decreased approximately 67% between 2013 and 2017. Medically important water-soluble antimicrobial use decreased substantially for most antimicrobials. Between 2013 and 2017, water-soluble penicillin use decreased approximately 42%, water-soluble tetracycline use decreased approximately 28%, and water-soluble lincomycin use decreased approximately 46%. Reducing the total amounts of antimicrobials used might be a crude indicator for mitigating the selection of antimicrobial resistance. Reducing the need for such use and verifying that treatment regimens deliver beneficial outcomes to animal health are more meaningful objectives.

Full-Service Twin Cities Mobile Market Impact: Qualitative Findings From Focus Groups With Customers.

BACKGROUND: Creative solutions are required to mitigate poor food access and related health disparities in underserved, at-risk populations because healthy food access is an important social determinant of health. Mobile markets (ie, mobile grocery stores) present a potential solution to mitigate poor food access and related health disparities. However, no research has yet evaluated the impact of a full-service mobile market that sells healthy items from all food groups and pantry staples in underserved communities. OBJECTIVE: Therefore, the objective of this focus group research study was to inductively understand the impact of the full-service, Twin Cities Mobile Market, a mobile grocery store, that visits underserved, low-income communities. DESIGN: Qualitative focus group research. PARTICIPANTS/SETTING: Four moderated and audio-recorded, qualitative focus groups with customers (n = 29) were held in community rooms at mobile market stops. ANALYSIS: Focus group transcripts were analyzed using Krueger's systematic analysis process and content analysis to discover major categories and themes and subthemes within the categories. RESULTS: Findings indicate the full-service mobile market may facilitate purchase and eating of healthy foods through decreasing barriers and increasing access to quality, affordable healthy foods. Findings also indicate mobile market shopping may positively influence customer behaviors and health outcomes (eg, dietary intake and management of weight, diabetes, blood pressure, and mental health). CONCLUSIONS: Our results provide support for the potential impact of full-service mobile markets, encouraging continued mobile market service and future rigorous research on the effectiveness of the full-service mobile market model.

Raising Animals Without Antibiotics: U.S. Producer and Veterinarian Experiences and Opinions.

Ensuring the safety, health, and overall well-being of animals raised for food is both an ethical obligation and a critical component of providing safe food products. The use of antibiotics for maintaining animal health has come under scrutiny in recent years due to the rise of antibiotic resistance globally. Some U.S. producers, especially in the poultry industry, have responded by eliminating their antibiotic use. The number of animals raised without antibiotics (RWA) is growing in the U.S., but there are concerns that RWA practices might negatively impact animal health and welfare. Therefore, the objective of this study was to survey U.S. veterinarians and producers about their experiences and opinions regarding RWA production. Veterinarians, farmers, ranchers, producers, and other stakeholders involved in raising broilers, turkeys, swine, beef cattle or dairy cattle were surveyed. Of the 565 completed responses received, 442 self-reported as practicing veterinarians or producers. Just over half of respondents reported having past or current experience with RWA programs. The main indicated reasons for raising animals without antibiotics were market driven; switching to RWA production was less commonly made for health-related reasons, such as to reduce antibiotic resistance or to improve animal health and welfare. Although respondents felt that RWA production has negative impacts on animal health and welfare, they overwhelmingly (>70%) indicated that the customer (retailer/restaurant/food service) believes that animal and health welfare will be significantly improved. Veterinarians and producers indicated that RWA programs will increase production costs with questionable effect on meat, egg or dairy consumer demand. Many respondents felt that there are times when the RWA label takes priority over animal health and welfare. Respondents generally felt that there was a need for increased auditing/assessment of animal health and welfare in RWA systems.