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Multiple studies have shown the value of early interventions for autism spectrum disorder (ASD). In the US, the Early Intervention Program (EIP) is mandated by law (Part C of the Individuals With Disabilities Education Act [IDEA]) to provide services to all young children with delays or disabilities. However, the extent to which children with ASD participate in this key service system is unknown.To evaluate EIP use by children with ASD from 2006 to 2016 and to describe the factors associated with EIP participation.This cross-sectional study used repeated data collected from 2006 to 2016 by active ASD surveillance of the New York-New Jersey metropolitan area as reported in the New Jersey Autism Study. The New Jersey Autism Study identified 4050 children aged 8 years with ASD from 2006 to 2016. Demographic and clinical data were collected and participation in an EIP was assessed through active surveillance. Data were analyzed from June to December 2021.Sociodemographic factors associated with the outcome of EIP participation.Participation in an EIP assessed at age 8 years. Demographic, ecological, and clinical factors, as well as temporal patterns, were examined by using standard and multilevel logistic regression models.Among 4050 children aged 8 years with ASD by active surveillance, 1887 (46.6%) received EIP services. Of these children, 3303 (81.6%) were boys; 1105 (27.3%) were Hispanic, 801 (19.8%) were non-Hispanic Black, 1816 (44.8%) were non-Hispanic White, and 328 (8.1%) were non-Hispanic other (included Alaska Native or American Indian and Asian or Pacific Islander). In adjusted regression models, non-Hispanic Black children with ASD had lower odds of EIP participation (adjusted odds ratio [AOR], 0.67; 95% CI, 0.54-0.84) compared with their non-Hispanic White peers, and children residing in affluent areas had higher odds of receiving EIP services (AOR, 1.71; 95% CI, 1.36-2.15) compared with children residing in underserved areas. Children with ASD born in 2008 had higher odds of EIP participation than children born in 1998 (AOR, 2.64; 95% CI, 2.07-3.36).Early identification of ASD is an important public health priority and receipt of EIP services may improve ASD outcomes. Approximately half of the population of children aged 8 years with ASD received EIP services between 2006 and 2016, and EIP participation by children with ASD increased during the 10-year period. However, receipt of EIP services was marked by strong socioeconomic status- and race and ethnicity-based disparities. Universal ASD screening and additional strategies are needed to address disparities and to increase access to EIP services.

BACKGROUND Intellectual ability predicts functional outcomes for children with autism spectrum disorder (ASD). It is essential to classify ASD children with and without intellectual disability (ID) to aid etiological research, provide services, and inform evidence-based educational and health planning. METHODS Using a cross-sectional study design, data from 2000 to 2016 active ASD surveillance among 8-year-olds residing in the New York-New Jersey Metropolitan Area were analyzed to determine ASD prevalence with and without ID. Multivariable Poisson regression models were used to identify trends for ASD with ID (ASD-I) and without ID (ASD-N). RESULTS Overall, 4661 8-year-olds were identified with ASD. Those that were ASI-I were 1505 (32.3%) and 2764 (59.3%) were ASD-N. Males were 3794 (81.4%), 946 (20.3%) were non-Hispanic Black (Black), 1230 (26.4%) were Hispanic, and 2114 (45.4%) were non-Hispanic white (white). We observed 2-fold and 5-fold increases in the prevalence of ASD-I and ASD-N, respectively, from 2000-2016. Black children were 30% less likely to be identified with ASD-N compared with white children. Children residing in affluent areas were 80% more likely to be identified with ASD-N compared with children in underserved areas. A greater proportion of children with ASD-I resided in vulnerable areas compared with children with ASD-N. Males had higher prevalence compared with females regardless of ID status; however, male-to-female ratios were slightly lower among ASD-I compared with ASD-N cases. CONCLUSIONS One-in-3 children with ASD had ID. Disparities in the identification of ASD without ID were observed among Black and Hispanic children as well as among children residing in underserved areas.

Axions and axion-like particles may couple to nuclear spins like a weak oscillating effective magnetic field, the "axion wind." Existing proposals for detecting the axion wind sourced by dark matter exploit analogies to nuclear magnetic resonance (NMR) and aim to detect the small transverse field generated when the axion wind resonantly tips the precessing spins in a polarized sample of material. We describe a new proposal using the homogeneous precession domain (HPD) of superfluid helium-3 as the detection medium, where the effect of the axion wind is a small shift in the precession frequency of a large-amplitude NMR signal. We argue that this setup can provide broadband detection of multiple axion masses simultaneously, and has competitive sensitivity to other axion wind experiments such as CASPEr-Wind at masses below $10^{-7}$ eV by exploiting precision frequency metrology in the readout stage., v2: typos fixed and references added. v1: 5+1 pages, 3 figures

Background: In 2007 the Centers for Disease Control and Prevention (CDC) reported a higher prevalence of autism spectrum disorder (ASD) in New Jersey, one of the wealthiest states in the United States, than in other surveillance regions. Objective: To examine the association of socioeconomic status (SES) with ASD prevalence. Methods: Information on eight-year-olds with ASD from four counties was abstracted from school and medical records. US Census 2000 provided population and median household income data. Results: 586 children with ASD were identified: autism prevalence was 10.2/1000, higher in boys than girls (16 vs. 4/1000); higher in white and Asian non-Hispanics than in black non-Hispanics and Hispanics (12.5, 14.0, 9.0, and 8.5/1000, respectively); and higher (17.2/1000 (95% CI 14.0–21.1)) in tracts with median income >US$90,000 than in tracts with median income ≤US$30,000 (7.1 (95% CI 5.7–8.9)). Number of professional evaluations was higher, and age at diagnosis younger, in higher income tracts ( p < .001), but both measures spanned a wide overlapping range in all SES levels. In multivariable models race/ethnicity did not predict ASD, but the prevalence ratio was 2.2 (95% CI 1.5–3.1) when comparing highest with lowest income tracts. Conclusions: In the US state of New Jersey, ASD prevalence is higher in wealthier census tracts, perhaps due to differential access to pediatric and developmental services.

(1995). Occupational Health and Safety Surveillance: Hazard Surveillance: Its Role in Primary Prevention of Occupational Disease and Injury. Applied Occupational and Environmental Hygiene: Vol. 10, No. 9, pp. 737-742.

To paraphrase D. A. Henderson, if the public health infrastructure were a living organism, public health surveillance would be its sensory organ system. It receives and processes data from its environment that subsequently impacts on the organism’s resulting actions. The appropriateness of those actions is dependent on the ‘‘health’’ of the sensory organs. More formally, public health surveillance is defined as ‘‘the ongoing, systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice, closely integrated with the timely dissemination of these data to those who need to know [1].’’ Surveillance activities provide evidence-based information vital to subsequent investigative, research, or prevention and control efforts but do not include those efforts [2]. Surveillance is the component of public health practice that provides the information assisting in directing the appropriate response. This applies to any public health surveillance system regardless of its purpose. This chapter will focus the discussion on public health surveillance issues relevant to bioterrorism. For those readers interested in pursuing more information on public health surveillance in general, the authors suggest Teutsch and Churchill’s [3] and Halperin and Baker’s [4] excellent texts on public health surveillance.

Background.In 2002, federal regulations authorized the use of standing orders programs (SOPs) for promoting influenza and pneumococcal vaccination. In 2003, the New Jersey Hospital Association conducted a demonstration project illustrating the efficacy of SOPs, and the state health department informed healthcare facilities of their benefits. We describe the prevalence of reported use of SOPs in New Jersey hospitals in 2003 and 2005 and identify hospital characteristics associated with the use of SOPs.Methods.A survey was mailed to the directors of infection control at 117 New Jersey hospitals during the period from January to May 2005 (response rate, 90.6%). Data on hospital characteristics were obtained from hospital directories and online resources.Results.The prevalence of use of SOPs for influenza vaccination was 50% (95% confidence interval [CI], 40.1%-59.9%) in 2003, and it increased to 78.3% (95% CI, 69.2%-85.7%) in 2005. The prevalence of SOP use for pneumococcal vaccination was similar. In 2005, the reported rate of use of SOPs for inpatients (influenza vaccination, 76.4%; pneumococcal vaccination, 75.5%) was significantly higher than that for outpatients (influenza vaccination, 9.4%; pneumococcal vaccination, 8.5%). Prevalence ratios for SOP use comparing acute care and non-acute care hospitals were 1.71 (95% CI, 1.2-2.5) for influenza vaccination SOPs and 1.8 for (95% CI, 1.2-2.7) pneumococcal vaccination SOPs. Acute care hospitals with a ratio of admissions to total beds greater than 36.7 reported greater use of SOPs for pneumococcal vaccination, compared with those that had a ratio of less than 36.7.Conclusion.The increase in the prevalence of reported use of SOPs among New Jersey hospitals in 2005, compared with 2003, was contemporaneous with SOP-related actions taken by the federal government, the state government, and the New Jersey Hospital Association. Opportunities persist for increased use of SOPs among non-acute care hospitals and for outpatients.

This study examined age-specific trends in the annual incidence rates of poisoning exposures reported to a regional poison control center over a 5-y period. Data from the poison control center's 1997-2001 computerized case records were combined with age-specific population estimates from the US Census Bureau. Incidence rates of reported poisoning exposures were calculated and evaluated for the following age groups:6 y; 6 to 12 y; 13 to 19 y; 20 to 35 y; 36 to 65 y; and65 years. Ordinary linear regression analysis revealed a statistically significant decreasing trend in the annual crude incidence rate of poisoning exposures/1.000 population (r2 = .87, slope = -.33 p = .02). Different patterns were observed in the rates of reported poisoning exposures between the 6 age groups. While there was a significant decrease in the rate of reported poisoning exposures in children6 y of age or less, and for adults 20-35 and 36-65 y-old, the incidence rate among children 6-12 y, adolescents, and people65 y-old showed no significant decreasing trend.

Few studies have investigated socioeconomic status (SES) and external causes of death (ie, deaths attributable to injuries). These deaths are of particular interest because they are potentially preventable and they represent the second leading cause of years of life lost under age 75.We studied 261,723 deaths from external causes in 27 states from 1984 to 1997 among employed persons age 20-64. Numerator data came from occupation on the death certificate. Occupation-specific denominator data came from the U.S. Census. A Nam-Powers SES score was assigned to each occupation based on its relative income and education in the U.S. Census.After adjusting for age, sex, year and race, SES was strongly associated with mortality from all external causes combined for men (rate ratios = 2.9, 2.3, 1.5, and 1.0 by ascending SES quartile), and to a lesser extent for women (rate ratios = 1.6, 1.0, 1.1, and 1.0). A similar pattern was seen for each of the specific external causes (motor vehicle deaths, suicide, homicide, injuries other than by motor vehicle, and medical complications).We estimate 41% of deaths from external causes are attributable to having a SES below the top quartile (both sexes combined).

The fateful span that runs from the start of the great German offensive in the West on March 21, 1918 to the signing of the armistice almost eight months later has often been treated. A quarter of a century ago, Harry R. Rudin covered the subject in a book' that has since become a classic. One of the latest accounts, rounded out with a selection of documents reproduced in extenso, comes from Pierre Renouvin, the distinguished diplomatic historian.2 Drawing upon French archival material until recently unexplored by researchers,3 examining systematically the currents of French public opinion and the press of several countries, utilizing not only the vast literature of the interwar period but also the rich array of primary sources and secondary works published during the following decades, Renouvin has produced an erudite and lucid study. Despite some original investigations conducted along the way, his primary aim is not to break new ground but rather to sift, synthesize, and reassess what we already know, to raise basic questions and to examine them in the light of this voluminous evidence. Precision and thoroughness we have every right to expect from a scholar like Renouvin. He does not disappoint us. However, even where his material is fresh, his approach is not. Aware, to be sure, of the social emphasis in the works of revisionist writers, he does not share the assumptions that underlie their view of the past. He is a traditionalist in the sense that he tends to follow paths and directions already marked out by historians who, like himself, choose to concentrate on the leadership roles of the men at the top. There is, of course, little room for novelty in any analysis of the failure of the German offensive or of the reasons why the imperial government in Berlin requested an armistice when it did. Similarly, earlier writers have dealt quite definitively with the oft-repeated charge of German right-wingers that the Reich's "unvanquished" army was "stabbed in the back" by assorted fomenters of revolution and "subversive" elements at home-civilians, pacifists, Freemasons, democrats, liberals, socialists, bolshevists, Jews. Renouvin, for his part, places himself quite close to the view underscored by Rudin4 and others and widely held outside of Germany: If such a treacherous act was committed, the principal culprit was not the home front but the German High Command, headed by the prestigious Field Marshal Paul von Hindenburg but completely dominated by his brilliant, masterful, and mercurial subordinate, General Erich Ludendorff. This point requires little elaboration, and

Without a Hohenzollern candidature for the Spanish throne, there might have been no Franco-Prussian War in 1870 despite the growing antagonism between the two countries. And without the Franco-Prussian War, there might have been no world war in 1914. To be sure, the armed clash was actually ushered in by the diplomatic crisis of July 1870, which moved through such high points as the Gramont declaration of the sixth; the churning up of public opinion on both sides of the Rhine; the French demand for "guarantees" after Prince Karl Anton's renunciation of the candidature on behalf of his son, Prince Leopold; the publication of the "edited" Ems dispatch together with its transmission via diplomatic channels to the governments of Europe; and finally, the French decision to stake everything on a recourse to arms. Nevertheless, it was the anterior staging of the Hohenzollern candidature, a move which could have preluded a substantial change in the respective power positions of France and Prussia, that constituted the crucial starting point. Little wonder that so many historians, professional or otherwise, have underscored the candidature, writing books about it or making it the theme of entire chapters or major articles. Long shrouded in a fog of misrepresentation deliberately fostered by Bismarck himself, the chancellor's decisive role in the affair emerged only bit by bit over a period of several decades. The picture thus pieced together destroyed quite completely the Bismarckian version; and French historians, almost without exception already convinced of the chancellor's culpability, naturally made the most of this. But most German historians, after some fleeting surprise and puzzlement over the great man's disingenuousness, quickly discerned or presupposed weighty reasons of state which, in their opinion, explained and even justified Bismarck's steadfast insistence that the Prussian government had not been involved. Reflecting here, as in so many contexts, their nation's semideification of Bismarck, all but one or two of these German scholars professed horror at the charge that his ardent advocacy of the Hohenzollern candidature was part of a long-nurtured scheme to force a Franco-Prussian confrontation. They readily conceded that he was neither disinclined to take risks whenever necessary nor blind to the imponderables in this particular instance; but they insisted that he was too responsible a statesman to seek a quarrel with France or any other country and that in any case he preferred diplomatic to warlike solutions if his country's honor and interests would not suffer thereby. According to them, Bismarck acted on the assumption, however arguable in the

During the closing years of Pius IX's pontificate the relations between church and state in Italy were marred by incessant and acrimonious strife. The occupation of Rome on September 20, 1870 had widened the breach between the civil and ecclesiastical authorities. The subsequent course of this feud brought no attenuation of existing animosities. The implacable hostility of the Vatican to the new order of things in the peninsula spurred the Italian government to take drastic measures against the church and its recalcitrant hierarchy. Decisive too in the launching of this concerted offensive was the eagerness of the country's rulers to accelerate the secularization of Italian life. To these recurrent assaults the Holy See invariably replied with a barrage of protests and denunciations which reverberated throughout the Catholic world. Each fresh crisis was accompanied by recriminations which threw into sharp relief the formidable barriers to an understanding between these seemingly irreconcilable foes.

MEU is a simple way of Measuring Efficient Utilization of hospital services. It looks at the part of the patient's hospital stay that depends on the tests and treatment required. Are these tests ordered in a way that does not waste time? Is the turnaround time from test ordering to reported results fast or slow? MEU produces a numerical index of efficient utilization; here are some of the ways it has been put to use.

MBOCA (4,4′ methylenebis (2-chloroaniline) is a structural analogue of benzidine and is carcinogenic in mice, rats, and dogs. MBOCA has not yet been demonstrated to be carcinogenic in humans and is not regulated as an occupational carcinogen in the United States. We report two noninvasive papillary tumors of the bladder identified in a screening study of 540 workers exposed to MBOCA during its production at a Michigan chemical plant from 1968 to 1979. Both tumors occurred in men under 30 years old who had never smoked. Although the prevalence of grade 1-2 tumors among asymptomatic males in this age group is unknown, the incidence of clinically apparent tumors on U.S. males aged 25-29 is only 1 per 100,000 per year. The detection of the two tumors in young, nonsmoking males is consistent with the hypothesis that MBOCA induces bladder neoplasms in humans.