Experiences of HIV/STD Providers in New York State During Hurricane Sandy: Strengths, Challenges, and Recommendations.

OBJECTIVES: The aim of this study was to assess strengths and challenges experienced by HIV/STD providers in providing care during the response to Hurricane Sandy (Sandy) in New York State, and their recommendations for future preparedness. METHODS: A mixed methods approach, including a focus group (n = 3), interviews (n = 3), and survey (n = 31) of HIV/STD providers, was used. Key words identified by means of open coding methodology from collected data were organized into strengths, challenges, and recommendations and then grouped into federal and study-associated preparedness capabilities. RESULTS: Key words were organized into 81 strengths (38.8%), 73 challenges (34.9%), and 55 recommendations (26.3%). Services most interrupted during Sandy were related to HIV/STD outreach and education. While providers reported challenges with external agency communication, the ability to still connect clients to needed resources was reported as a strength. Strengthening partnerships with federal, state, and local agencies was among the major recommendations made by these providers. CONCLUSIONS: This study presents unique information about challenges experienced by HIV/STD providers in providing services during a natural disaster and the use of national public health emergency preparedness capabilities to address and overcome those challenges. Lessons learned and recommendations regarding inter-agency communications emerged as an important priority during a natural disaster to minimize or reduce service interruption.

Salmonella and the changing environment: systematic review using New York State as a model.

Salmonella is a public health concern, for which a complex interplay between host, agent, and environment exists. An improved understanding of causal processes can be used to better gauge the causes and trajectory of Salmonella in a changing environment. This would be useful in determining the impact of climate change on the New York State (NYS) environment, the effect of climate change on Salmonella in NYS, factors contributing to Salmonella vulnerability in humans, and aspects of climate change and Salmonella which necessitate further research. A systematic review was conducted to study associations between Salmonella and the environment. Using the search criteria, a total of 91 relevant articles were identified from four electronic databases. Key information was abstracted, organized, and synthesized to identify causal processes and linkages between climate change, the environment of NYS, and Salmonella-related outcomes, as well as risk factors to characterize Salmonella vulnerabilities. Three inter-related domains were identified for consideration and application to epidemiological research to confirm and extrapolate disease patterns using climate change scenarios: improved quantification of causal relationships, inclusion of factors linked to sectors not immediately associated with the exposure and outcome, and increased capacity to validate models in diverse settings.

Superstorm Sandy's impact on the provision of WIC (Special Supplemental Nutrition Program for Women, Infants, and Children) services in New York State.

OBJECTIVE: Services provided by the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) were interrupted in 2012 when Superstorm Sandy struck New York State (NYS). The present study evaluates the impact on WIC providers. DESIGN: A focus group, telephone interviews and anonymous online survey were conducted. Qualitative data were analysed by coding transcribed text into key words and identifying major and minor themes for strengths, challenges and recommendations using national public health preparedness capabilities. Survey responses were analysed quantitatively; reported challenges were classified by preparedness capability. SETTING: The focus group was held at a 2014 regional WIC meeting. Interviews and a survey were conducted via telephone in 2014 and online in 2015, respectively. SUBJECTS: WIC staff representing New York City and three NYS counties. RESULTS: In the focus group (n 12) and interviews (n 6), 'emergency operations coordination' was the most cited capability as a strength, 'environmental health protection' (against environmental hazards) as a challenge and 'flexibility' (on rules and procedures) as a recommendation. In the survey (n 24), the capability 'information sharing' was most often cited as a challenge. Most staff (66·6 %) reported their programmes were at least somewhat prepared for future weather-related disasters. Only 16·7 % indicated having practiced a work-related emergency response plan since Sandy. Staff who practiced an emergency response plan were more likely to indicate they were prepared (P < 0·05). CONCLUSIONS: The study identified WIC programme areas requiring preparedness improvements. The research methodology can be utilized to assess the continuity of other public health services during disasters.

New York State Public Health System Response to Hurricane Sandy: Lessons From the Field.

OBJECTIVE: The aim of this study was to conduct interviews with public health staff who responded to Hurricane Sandy and to analyze their feedback to assess response strengths and challenges and recommend improvements for future disaster preparedness and response. METHODS: Qualitative analysis was conducted of information from individual confidential interviews with 35 staff from 3 local health departments in New York State (NYS) impacted by Hurricane Sandy and the NYS Department of Health. Staff were asked about their experiences during Hurricane Sandy and their recommendations for improvements. Open coding was used to analyze interview transcripts for reoccurring themes, which were labeled as strengths, challenges, or recommendations and then categorized into public health preparedness capabilities. RESULTS: The most commonly cited strengths, challenges, and recommendations related to the Hurricane Sandy public health response in NYS were within the emergency operations coordination preparedness capability, which includes the abilities of health department staff to partner among government agencies, coordinate with emergency operation centers, conduct routine conference calls with partners, and manage resources. CONCLUSIONS: Health departments should ensure that emergency planning includes protocols to coordinate backup staffing, delineation of services that can be halted during disasters, clear guidelines to coordinate resources across agencies, and training for transitioning into unfamiliar disaster response roles. (Disaster Med Public Health Preparedness. 2016;10:443-453).

New York State Public Health System Response to Hurricane Sandy: An Analysis of Survey Feedback.

OBJECTIVE: The objective was to provide a broad spectrum of New York State and local public health staff the opportunity to contribute anonymous feedback on their own and their agencies' preparedness and response to Hurricane Sandy, perceived challenges, and recommendations for preparedness improvement. METHODS: In 2015, 2 years after Hurricane Sandy, public health staff who worked on Hurricane Sandy response were identified and were provided a link to the anonymous survey. Quantitative analyses were used for survey ratings and qualitative content analyses were used for open-ended questions. RESULTS: Surveys were completed by 129 local health department (LHD) staff in 3 counties heavily impacted by Sandy (Nassau, Suffolk, and Westchester) and 69 staff in the New York State Department of Health who supported the LHDs. Staff agreed that their Hurricane Sandy responsibilities were clearly defined and that they had access to adequate information to perform their jobs. Challenges were reported in the operational, communication, service interruptions, and staff categories, with LHD staff also reporting challenges with shelters. CONCLUSIONS: New York local and state public health staff indicated that they were prepared for Hurricane Sandy. However, their feedback identified specific challenges and recommendations that can be addressed to implement improved preparedness and response strategies. (Disaster Med Public Health Preparedness. 2016;10:454-462).

New York State Public Health System Response to Hurricane Sandy: An Analysis of Emergency Reports.

OBJECTIVE: Analyzing Hurricane Sandy emergency reports to assess the New York State (NYS) public health system response will help inform and improve future disaster preparedness and response. METHODS: Qualitative analysis of NYS Department of Health (NYSDOH) and Nassau and Suffolk County local health department (LHD) emergency reports was conducted. Three after-action reports and 48 situation reports were reviewed, grouped by key words and sorted into 16 Public Health Preparedness Capabilities. Within each capability, key words were labeled as strengths, challenges, or recommendations. RESULTS: The NYSDOH capability most cited as a strength was successful emergency operations coordination, eg, interagency conference calls (27.4% of 1681 strengths). The most cited challenge was environmental health protection, eg, mold and oil spills (28% of 706 challenges). The LHD capability most cited both as a strength (46.7% of 30 strengths) and as a challenge (32.5% of 123 challenges) was emergency operations coordination. Strengths were exemplified by sharing local resources and challenges by insufficient memorandums of understanding for coordination. CONCLUSIONS: Post-disaster emergency reports should be systematically reviewed to highlight both successes and areas for improvement. Future studies should prioritize collecting feedback from a wider spectrum of public health and service provider staff for planning of preparedness and response activities. (Disaster Med Public Health Preparedness. 2015;10:308-313).

Variations at a quantitative trait locus (QTL) affect development of behavior in lead-exposed Drosophila melanogaster.

We developed Drosophila melanogaster as a model to study correlated behavioral, neuronal and genetic effects of the neurotoxin lead, known to affect cognitive and behavioral development in children. We showed that, as in vertebrates, lead affects both synaptic development and complex behaviors (courtship, fecundity, locomotor activity) in Drosophila. By assessing differential behavioral responses to developmental lead exposure among recombinant inbred Drosophila lines (RI), derived from parental lines Oregon R and Russian 2b, we have now identified a genotype by environment interaction (GEI) for a behavioral trait affected by lead. Drosophila Activity Monitors (TriKinetics, Waltham, MA), which measure activity by counting the number of times a single fly in a small glass tube walks through an infrared beam aimed at the middle of the tube, were used to measure activity of flies, reared from eggs to 4 days of adult age on either control or lead-contaminated medium, from each of 75 RI lines. We observed a significant statistical association between the effect of lead on Average Daytime Activity (ADA) across lines and one marker locus, 30AB, on chromosome 2; we define this as a Quantitative Trait Locus (QTL) associated with behavioral effects of developmental lead exposure. When 30AB was from Russian 2b, lead significantly increased locomotor activity, whereas, when 30AB was from Oregon R, lead decreased it. 30AB contains about 125 genes among which are likely "candidate genes" for the observed lead-dependent behavioral changes. Drosophila are thus a useful, underutilized model for studying behavioral, synaptic and genetic changes following chronic exposure to lead or other neurotoxins during development.