Digital Commons Network^™

The Epidemic Of Extended-Spectrum-Β-Lactamase-Producing Escherichia Coli St131 Is Driven By A Single Highly Pathogenic Subclone, H30-Rx, Lance B. Price, James R. Johnson, Maliha Aziz, Connie Clabots, Brian Johnston, Veronika Tchesnokova, Lora Nordstrom, Maria Billig, Sujay Chattopadhyay, Marc Stegger, Paal S. Andersen, Talima Pearson, Kim Riddell, Peggy Rogers, Delia Scholes, Barbara Kahl, Paul Keim, Evgeni V. Sokurenko

Environmental and Occupational Health Faculty Publications

The Escherichia coli sequence type 131 (ST131) clone is notorious for extraintestinal infections, fluoroquinolone resistance, and extended-spectrum beta-lactamase (ESBL) production, attributable to a CTX-M-15-encoding mobile element. Here, we applied pulsed-field gel electrophoresis (PFGE) and whole-genome sequencing to reconstruct the evolutionary history of the ST131 clone. PFGE-based cluster analyses suggested that both fluoroquinolone resistance and ESBL production had been acquired by multiple ST131 sublineages through independent genetic events. In contrast, the more robust whole-genome-sequence-based phylogenomic analysis revealed that fluoroquinolone resistance was confined almost entirely to a single, rapidly expanding ST131 subclone, designated H30-R. Strikingly, 91% of the CTX-M-15-producing isolates also …

Work Stress Reactivity And Health Outcomes: A Study Of Nurses, Laurie Marie Jacobs

Dissertations and Theses

Negative events encountered in daily life influence individual well-being. Individuals vary in their reactivity to these events, the extent to which they are behaviorally, physiologically, and psychologically influenced by them (Almeida, 2005; Neupert, Almeida, & Charles, 2007). Reactivity to events in the form of changes in health behavior could represent either an attempt at coping (Cooper, Frone, Russell, & Mudar, 1995) or a stressor-related failure of self-control (Muraven & Baumeister, 2000). Such changes in behavior could have later effects on health.

Although a great deal of attention has been paid to both the immediate and long-term effects of stressors on …

Molecular Epidemiology Of Escherichia Coli Sequence Type 131 And Its H30 And H30-Rx Subclones Among Extended-Spectrum-Β-Lactamase-Positive And -Negative E. Coli Clinical Isolates From The Chicago Region, 2007 To 2010, Ritu Banerjee, Ari Robicsek, Michael A. Kusikowski, Stephen Porter, Brian D. Johnston, Evgeni Sokurenko, Veronika Tchesnokova, Lance B. Price, James R. Johnson

Environmental and Occupational Health Faculty Publications

We assessed Escherichia coli ST131 and its H30 and H30-Rx subclones for virulence genes, antimicrobial resistance, and extended-spectrum beta-lactamase (ESBL) type. Although both subclones were associated with ESBL production, H30-Rx isolates had higher resistance scores and were associated specifically with CTX-M-15. Three virulence genes (iha, sat, and iutA) were more prevalent among H30 than non-H30 ST131 isolates. Thus, the H30 and H30-Rx subclones are more antimicrobial resistant and have virulence profiles that are distinct from those of non-H30 ST131 isolates.

Trends In Work-Related Injury Rates And The Associated Incurred Costs In Long-Term Care Centers, Darcie Lange Olson

Theses and Dissertations

Background. Nursing assistants, working in long-term care facilities, have consistently been among the top occupational groups experiencing work-related musculoskeletal injuries. These injuries have been attributed the physical demands of lifting and moving the individuals in their care. Great strides in research have identified successful risk reduction strategies such as the implementation safe patient handling and mobility programs. The benefits of these programs have been advocated over the last two decades, but the rate of injuries among nursing assistants continues to be more than double the national average for all other industries. The purpose of this study was to investigate the …

Feasibility And Preliminary Outcomes From A Pilot Study Of The Smile Curriculum For Mother-Infant Co-Occupational Engagement And Maternal Self-Efficacy, Emily Whitlock

Theses and Dissertations

OBJECTIVE: To report on the feasibility and preliminary outcomes from a pilot study of the SMILE curriculum, a new educational program designed to enhance the mother-infant relationship by focusing on improvement of co-occupational engagement within daily routines.

METHOD: Six mothers, each with an infant diagnosed with special medical needs who received services in a local birth-to-three program, participated in an exploratory design study. Each mother was assigned to a SMILE curriculum intervention group or a waiting-list control group. Mothers were evaluated pre- and post-intervention using the Perceived Maternal Parenting Self-Efficacy (PMP-SE) Scale for measurement of maternal self-efficacy and the Center …

Truck Driver Dies When Tractor-Trailer Leaves The Road And Plunges Into A Creek-Bed, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the early morning hours of a fall day, exact time unknown and the length of time driving unknown, a 28-year-old male truck driver was driving north on an interstate transporting 30,000 lbs. of blue plastic injection molding pellets. The truck driver exited the highway behind a guardrail and traveled 1,320 feet, striking a wire fence and several trees before plummeting into a creek bed, shearing the cab open. At 10:27 a.m., a citizen called in to the fire department to report a mysterious blue substance observed in the creek a couple of miles down from the accident. The fire …

Rapid Differentiation Between Livestock-Associated And Livestock-Independent Staphylococcus Aureus Cc398 Clades, Marc Stegger, Cindy M. Liu, Jesper Larsen, Katerina Soldanova, Maliha Aziz, Tania Contente-Cuomo, Andreas Petersen, Stien Vandendriessche, Judy N. Jiménez, Caterina Mammina, Alex Van Belkum, Saara Salmenlinna, Frederic Laurent, Robert L. Skov, Anders R. Larsen, Paal S. Andersen, Lance B. Price

Environmental and Occupational Health Faculty Publications

Staphylococcus aureus clonal complex 398 (CC398) isolates cluster into two distinct phylogenetic clades based on single-nucleotide polymorphisms (SNPs) revealing a basal human clade and a more derived livestock clade. The scn and tet(M) genes are strongly associated with the human and the livestock clade, respectively, due to loss and acquisition of mobile genetic elements. We present canonical single-nucleotide polymorphism (canSNP) assays that differentiate the two major host-associated S. aureus CC398 clades and a duplex PCR assay for detection of scn and tet(M). The canSNP assays correctly placed 88 S. aureusCC398 isolates from a reference collection into …

Arborists Die After Falling, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To Prevent Arborists Injuries:

• Never allow an aerial lift to be used as a crane or material lifting device.
• All trees and limbs should be inspected for structural weakness such as rot, before work starts.
• Arborists should wear appropriate personal protective equipment while performing tree trimming activities.

Special Factors for Aerial Lifts:

• Do not exceed the boom and basket load limits specified by the manufacturer.
• When working from an aerial lift, use a body harness that is properly attached.

How Could, Should, And Would Physicians Use Facebook With Patients, Joy Peluchette, Katherine Karl, Alberto Coustasse

Management Faculty Research

After reviewing the benefits and risks of social media, we examine online discussion boards to determine the thoughts of physicians and patients regarding the use of Facebook to communicate with one another about health-related issues. Of the 290 comments analyzed, we found 42 percent were opposed to physicians using Facebook. Additionally, most (51.7 were opposed to physicians being Facebook “friends” with patients. Most opponents expressed concerns about privacy and the need to maintain professional boundaries in the physician-patient relationship. We provide suggestions for how healthcare administrators can effectively manage their social media presence and provide assistance to physicians.

Situational Awareness: Reframing Within Fire Service Culture, Martha Dow, Len Garis, Larry Thomas

Publications and Research

There is increasing attention being paid to better understanding and consequently decreasing the incidence of on-the-job injuries and deaths within the fire service across North America. Heightening situational awareness is being explored as the most critical factor in maintaining the safety of participants in high risk, low frequency events. Situational awareness is generally defined as “understanding the current environment and being able to accurately anticipate future problems to enable effective action”. Situational awareness is cited as a critical factor in most research exploring safety in fire suppression activities and in many cases the “No. 1 factor identified by firefighters filing …

White Paper On Pcbs In The Built Environment, Andre Barton Ashley Jr., Cheryl Marcham, Et Al.

Publications

Dr. Marcham was part of the 9-member team that wrote this paper. Polychlorinated biphenyls (PCBs) are a group of man-made chemicals associated with a potential risk to human health and the environment. They were used in many building materials, particularly caulking, grout, expansion joint material and paint, from approximately 1950 to 1978. Both the U.S. Environmental Protection Agency (EPA) and the Agency for Toxic Substances and Disease Registry (ATSDR) have published extensive material evaluating human health impacts from exposure to PCBs. The apparent public health risks, including developmental effects in children, reproductive effects and long-term risks for cancer development, have …

Epidemiology Of Esophageal Cancer, Yuwei Zhang

Environmental and Occupational Health Faculty Publications

Esophageal cancer (EsC) is one of the least studied and deadliest cancers worldwide because of its extremely aggressive nature and poor survival rate. It ranks sixth among all cancers in mortality. In retrospective studies of EsC, smoking, hot tea drinking, red meat consumption, poor oral health, low intake of fresh fruit and vegetables, and low socioeconomic status have been associated with a higher risk of esophageal squamous cell carcinoma. Barrett’s esophagus is clearly recognized as a risk factor for EsC, and dysplasia remains the only factor useful for identifying patients at increased risk, for the development of esophageal adenocarcinoma in …

Allostatic Load Amplifies The Effect Of Blood Lead Levels On Elevated Blood Pressure Among Middle-Aged U.S. Adults: A Cross-Sectional Study, Ami R. Zota, Edmond R. Shenassa, Rachel Morello-Frosch

Environmental and Occupational Health Faculty Publications

Background

Scientists and regulators have sought to understand whether and how physiologic dysregulation due to chronic stress exposure may enhance vulnerability to the adverse health effects of toxicant exposures. We conducted a cross-sectional study to determine whether allostatic load (AL), a composite measure of physiologic response to chronic exposure to stress, amplifies the effect of lead exposure on blood pressure among middle-aged adults.

Methods

We analyzed associations between blood lead levels and blood pressure in a nationally representative sample of 8,194 U.S. adults (aged 40-65 years) participating in the National Health and Nutritional Examination Survey, 1999--2008. Outcomes were elevated systolic …

Livestock-Associated Methicillin And Multidrug Resistant Staphylococcus Aureus Is Present Among Industrial, Not Antibiotic-Free Livestock Operation Workers In North Carolina, Jessica L. Rinsky, Maya Nadimpalli, Steve Wing, Devon Hall, Dothula Baron, Lance B. Price, Jesper Larsen, Marc Stegger, Jill Stewart, Christopher D. Heaney

Environmental and Occupational Health Faculty Publications

Objectives

Administration of antibiotics to food animals may select for drug-resistant pathogens of clinical significance, such as methicillin-resistant Staphylococcus aureus (MRSA). In the United States, studies have examined prevalence of MRSA carriage among individuals exposed to livestock, but prevalence of multidrug-resistant S. aureus (MDRSA) carriage and the association with livestock raised with versus without antibiotic selective pressure remains unclear. We aimed to examine prevalence, antibiotic susceptibility, and molecular characteristics of S. aureus among industrial livestock operation (ILO) and antibiotic-free livestock operation (AFLO) workers and household members in North Carolina.

Methods

Participants in this cross-sectional study were interviewed and provided a …

Factory Laborer Dies When A Car Driven By Coworker Crashes Into Him In Parking Lot, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

On a summer day, a 29-year-old male manufacturing laborer was outside under a small metal stairway in the loading dock area of the manufacturing plant during his lunch break. Another employee entered her car in the employee parking lot to leave on her lunch break. Her car unexpectedly malfunctioned when in reverse, sped backward, and crashed into the stairway under which the worker was taking a break. The collision pushed the metal stairway along the wall of the factory, crushing the worker between the building and the passenger side of the car. Emergency medical services arrived and transported the worker …

The Effect Of The Sphere Standards On The Incidence Of Communicable And Infectious Diseases In A Complex Humanitarian Emergency, Masashi Rotte

Master of Public Health Capstone Presentations

The purpose of this study was to determine what effect achieving the Sphere Standards relating to water and sanitation had on the incidence of communicable diseases in a returnee camp in South Sudan during a complex humanitarian emergency. The water and sanitation infrastructure of the returnee camp was tracked over time until it met the Sphere Standards. The total camp population was also tracked over the same period of time and compared to daily counts of diseases diagnosed in a medical clinic at the camp. A daily incidence of disease was then calculated for each communicable disease that was tracked. …

Day Care Monitor Dies After Crash Of 15-Passenger Van, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the late afternoon of a spring day, a day care van operator and a monitor loaded 16 children into a 15-passenger van. Carrying a total of 18 passengers in the 15-passenger van, the operator and the monitor proceeded to transport the children to their homes. After dropping off two children at their residences, the van was traveling 46-50 mph in the left hand lane headed east in a 35 mph zone on a non-divided four-lane state road. As the van approached a side street on the right, the right rear tire blew out and the van veered sharply to …

Exploring Changes In Open Defecation Prevalence In Sub-Saharan Africa Based On National Level Indices, Deise I. Galan, Seung-Sup Kim, Jay P. Graham

Environmental and Occupational Health Faculty Publications

Background

In sub-Saharan Africa, it is estimated that 215 million people continue to engage in open defecation. This practice facilitates the transmission of diarrheal diseases – one of the leading causes of mortality in children under 5 in sub-Saharan Africa. The main purpose of this study is to: estimate changes in open defecation prevalence between 2005 and 2010 across countries in sub-Saharan Africa; examine the association between national level indices and changes in open defecation prevalence; and assess how many countries can achieve ‘open defecation free status’ by 2015.

Methods

After applying selection criteria, this study analyzed country-level data for …

Analisis Implementasi Sistem Tanggap Darurat Berdasarkan Asosiasi Perlindungan Kebakaran Nasional 1600, Meilissa Ayu Pratiwi, Fatma Lestari, Ridwansyah Ridwansyah

Kesmas

Penelitian kesesuaian pelaksanaan sistem tanggap darurat di PT X menjadi upaya untuk mempersiapkan proses tanggap darurat. Penelitian kualitatif dengan desain studi deskriptif analitik ini menggunakan dua jenis data meliputi data primer yang didapatkan melalui wawancara dan observasi, serta data sekunder melalui telaah dokumen. Tujuan penelitian ini adalah mengetahui kesesuaian implementasi sistem tanggap darurat di PT X Perusahaan Pelayanan Gas dan Minyak, ditinjau dari National Fire Protection Association 1600 (NFPA 1600) tahun 2012. Pada penelitian ini didapatkan kesesuaian implementasi sistem tanggap darurat PT X berdasarkan NFPA 1600 adalah 36,23%, sedangkan ketidaksesuainya adalah 37,60%. Diharapkan dapat mempertimbangkan saran yang diberikan untuk meningkatkan …

Model Kuantitatif Manajemen Kelelahan Dan Beban Kerja Untuk Peningkatan Produktivitas Pekerja Penggilingan Padi, Nur Ulfah, Panuwun Joko Nurcahyo, Irfan Dwiandhono

Kesmas

Sumber daya manusia merupakan aset penting bagi perusahaan dalam rangka peningkatan produk yang dihasilkan, salah satunya adalah sumber daya pekerja. Pekerja dengan beban kerja yang berat akan mengakibatkan terjadinya kelelahan yang pada akhirnya dapat menurunkan kualitas produk yang dihasilkan. Tujuan penelitian ini adalah mengembangkan model kuantitatif manajemen kelelahan dan beban kerja untuk meningkatkan produktivitas. Adapun metode penelitian yang digunakan adalah survei eksplanatori dengan pendekatan cross sectional dengan sampel sebanyak 45 pekerja penggilingan padi. Hasil analisis menunjukkan bahwa variabel kelelahan kerja maupun beban kerja mempunyai hubungan yang signifikan dengan produktivitas kerja. Model persamaan regresi yang terbentuk adalah produktivitas kerja = -4,188 …

Genome Analysis Of Staphylococcus Aureus St291, A Double Locus Variant Of St398, Reveals A Distinct Genetic Lineage, Marc Stegger, Maliha Aziz, Tomsz Chroboczek, Lance B. Price, Troels Ronco, Kristoffer Kiil, Robert L. Skov, Frederic Laurent, Paal S. Andersen

Environmental and Occupational Health Faculty Publications

Staphylococcus aureus ST291 has been reported as a homologue recombinant double locus variant of the livestock associated S. aureus ST398. However, whole genome sequencing show that ST291 is a unique genetic lineage with highly variable content within its accessory genome compared to both human and livestock associated genome sequenced CC398s.

Truck Driver Dies When Tractor-Trailer Overturns After Leaving Road, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Motor Vehicle

In the early morning hours of a spring day around 5:45 a.m., a 55-year-old male truck driver was driving south on an interstate transporting sheet metal. It is unknown how long he had been driving when he exited from the highway, traveled partially up the ramp, and struck the left side guard rail. The truck left the road, traveled down an embankment and overturned onto its roof. A passing motorist called emergency medical services. The driver was extricated by mechanical means and declared dead at the scene.

To prevent future occurrences of similar incidents, the following recommendations have been made: …

Firefighter Fitness-For-Duty Medical Screening: A Peer Review Quality Improvement Pilot, Julie Collings Rochefort

UNLV Theses, Dissertations, Professional Papers, and Capstones

Despite the overwhelming evidence that sudden cardiac death is the most frequent cause of firefighter fatalities, many fire departments do not have a program to measure or maintain basic firefighter fitness and health. This project evaluated and compared medical screening outcomes of four industrial fire brigades within a multinational oil and gas corporation and introduced a quality improvement plan. The goal of this project was to apply the evidence and measure outcomes to determine the most effective way to ensure that firefighters in a corporate setting are healthy. This was accomplished by utilizing established guidelines in developing an educational program …

O Cuidador De Enfermagem E O Cuidar Em Uma Unidade De Terapia Intensiva / The Nursing Caregiver And The Caring In Intensive Care Units, Everton Alves

Everton Fernando Alves

Diversos fatores são considerados agressivos em uma Unidade de Terapia Intensiva (UTI), os quais não atingem apenas os pacientes, mas também os cuidadores de enfermagem, uma vez que estes participam desde procedimentos complexos até morte de pacientes. Dessa forma, muitos cuidadores de enfermagem passam por dificuldades em sua rotina diária que influenciam o modo de cuidar. O objetivo deste estudo foi identificar os aspectos vivenciados pelos cuidadores de enfermagem que atuam em uma UTI - Adulto. Trata-se de um estudo exploratório-descritivo, de abordagem qualitativa, desenvolvido junto a 21 cuidadores de enfermagem da UTI - Adulto de um hospital escola do …

Promosi Pengetahuan, Sikap, Dan Keterampilan Berpola Hidup Sehat Pada Kelompok Senam, L. Meily Kurniawidjaja, Dadan Erwandi, Ike Pujiriani

Kesmas

Pendirian grup senam masyarakat perkotaan sering dipicu oleh ancaman penyakit jantung koroner dan stroke (penyakit kardiovaskular). Banyak diantara mereka masih berisiko tinggi penyakit kardiovaskular antara lain berat badan lebih dan kadar kolesterol tinggi serta faktor umur dan genetik, tetapi faktor risiko penyakit kardiovaskular dapat diturunkan dengan pola hidup sehat. Tujuan penelitian ini adalah menilai pengaruh metode promosi kesehatan dengan pendekatan siklus rekognisi, analisis, perencanaan, komunikasi, persiapan, implementasi, evaluasi, dan kelanjutan dapat meningkatkan pengetahuan, sikap dan praktik ibu-ibu pesenam tentang pola hidup sehat. Penelitian ini menggunakan pretest and posttest design untuk menilai hasil intervensi pada 60 orang berusia rata-rata 58,26 tahun …

Male Circumcision Significantly Reduces Prevalence And Load Of Genital Anaerobic Bacteria, Cindy M. Liu, Bruce A. Hungate, Aaron A.R. Tobian, David Serwadda, Jacques Ravel, Richard Lester, Godfrey Kigozi, Maliha Aziz, Ronald M. Galiwango, Fred Nalugoda, Tania L. Contente-Cuomo, Maria J. Wawer, Paul Keim, Ronald H. Gray, Lance B. Price

Environmental and Occupational Health Faculty Publications

Male circumcision reduces female-to-male HIV transmission. Hypothesized mechanisms for this protective effect include decreased HIV target cell recruitment and activation due to changes in the penis microbiome. We compared the coronal sulcus microbiota of men from a group of uncircumcised controls (n= 77) and from a circumcised intervention group (n = 79) at enrollment and year 1 follow-up in a randomized circumcision trial in Rakai, Uganda. We characterized microbiota using16S rRNA gene-based quantitative PCR (qPCR) and pyrosequencing, log response ratio (LRR), Bayesian classification, nonmetric multidimensional scaling (nMDS), and permutational multivariate analysis of variance (PerMANOVA). At baseline, men …

Fall Safety Assessment At The New School Of Public Health And Health Services Building, Amanda Mcqueen, Seung-Sup Kim, Melissa J. Perry

GW Research Days 2013

Objective: Falls are one of the leading causes of workplace death, lost work time, and costs to industry, particularly in construction. The public health burden of falls is significant, as approximately 25% of nonfatal injuries and 38% of fatalities in the general construction industry are due to falls. The goal of this study is to develop an assessment tool to evaluate fall safety in general construction and to evaluate fall safety among five skilled construction trades (i.e. electricians, painters, carpenters, welders, and roofers) throughout different stages of a new building construction project. The project is the new School of Public …

Workers Killed Due To Driver Distraction, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Motor Vehicle

To Prevent Driver Distraction,

Employers should:

• Provide training on the importance of being attentive and not engaging in distracting tasks or behaviors while driving
• Develop policies that minimize or eliminate the use of in-vehicle devices while driving

Employees should:

• Not use dispatching devices while driving
• Not text or manually dial a cell phone while driving
• Refrain from activities such as reading, writing or map reading while driving

Access To Chemical Data Used In Regulatory Decision Making, Lynn R. Goldman, Ellen K. Silbergeld, Randall Lutter, Craig Barrow, Christopher J. Borgert, James W. Conrad Jr., Debra Edwards, Allan Felsot

Environmental and Occupational Health Faculty Publications

No abstract provided.

Pit Latrines And Their Impacts On Groundwater Quality: A Systematic Review, Jay P. Graham, Matthew L. Polizzotto

Environmental and Occupational Health Faculty Publications

Background: Pit latrines are one of the most common human excreta disposal systems in low-income countries, and their use is on the rise as countries aim to meet the sanitation-related target of the Millennium Development Goals. There is concern, however, that discharges of chemical and microbial contaminants from pit latrines to groundwater may negatively affect human health.

Objectives: Our goals were to a) calculate global pit latrine coverage, b) systematically review empirical studies of the impacts of pit latrines on groundwater quality, c) evaluate latrine siting standards, and d) identify knowledge gaps regarding the potential for …