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A majority of grantees grounded their CHPR in collaboration with local Environmental Public Health Tracking (EPHT) programs, whether to develop baseline assessments of climate relevant health outcomes or to enhance monitoring of climate-related health indicators and outcomes, such as HRI or Lyme disease (e.g., MDPH 2014; NYSDH 2015; OHA 2014).
For example, New York State's CHPR outlines a structure with four crosscutting climate impact teams setting the goal of shifting climate change from an environmental to a public health issue (NYSDH 2015).
Needs assessment surveys of health department staff knowledge regarding climate and health population vulnerability factors provided insights based on direct experience and highlighted differences in perceptions across stakeholders regarding partnerships; for example, health department staff prioritized collaboration with emergency management services, while external stakeholders considered partnerships with schools and agencies to be more critical (NYSDH 2015).
To achieve sufficient statistical power from a large number of PT challenges over the study period, phase 1 included 22 certified clinical laboratories participating in both the NYSDH and WSLH PT programs for BPb.
In phase 1, clinical laboratories were selected for a blinded assessment of laboratory performance in the following manner: A list of laboratories that participate in the NYSDH BPb PT program was matched with one from the WSLH BPb PT program.
We limited the selection to laboratories that analyze capillary whole-blood (micro) specimens for BPb, and because we confined phase 2 to a single test event in the NYSDH PT program, we concentrated on identifying laboratories that participate in the NYSDH PT program but not in the WSLH program.
In phase 1 of this study, 848 blind PT samples were distributed to 22 certified BPb laboratories participating in up to 4 NYSDH events (20 PT samples) and up to 16 WSLH events (48 samples).
Another example of potential selection bias in phase 1 was the limitation of study participants to laboratories participating in both the NYSDH and WSLH PT programs for BPb.
Although the five blinded PT challenges from the NYSDH PT events were separated into groups of two and three and distributed over a 2-week time frame, one phase 1 participant and one phase 2 participant suspected that PT samples were being referred for BPb analysis by another testing laboratory, a practice that is not permitted under the NYSDH program regulations.
No other unexplained cases of malaria were reported to NYSDH during July 1 -- August 31, 1999.
The NYSDH is planning to conduct epidemiologic studies to evaluate the association between DEET and neurologic events.
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