Medicine and Health Sciences Commons^™

“For Lack Of Knowledge, Our People Will Perish”: Using Focus Group Methodology To Explore African-American Communities’ Perceptions Of Breast Cancer And The Environment, Kaleea Lewis, Shibani Kulkarni, Swann Arp Adams, Heather M. Brandt, Jamie R. Lead, John R. Ureda, Delores Fedrick, Chris Mathews, Daniela B. Friedman

Faculty Publications

Among women living in the United States, breast cancer is the second leading cause of cancer death. Disproportionate racial disparities in breast cancer exist, with African American (AA) women consistently having the highest rates of breast cancer related mortality despite lower incidence. This study attends to the Institute of Medicine's (IOM) call to action recommending the identification of effective strategies for communicating accurate and reliable breast cancer risk information to diverse audiences. Using focus group methodology, this study explores how AAs perceive and decipher information related to breast cancer and its relationship to their environment. Six focus groups were conducted. …

Understanding Dyslexia In The Context Of Developmental Language Disorders, Suzanne M. Adlof, Tiffany P. Hogan

Faculty Publications

Purpose: The purpose of this tutorial is to discuss the language basis of dyslexia in the context of developmental language disorders (DLDs). Whereas most studies have focused on the phonological skills of children with dyslexia, we bring attention to broader language skills. Method: We conducted a focused literature review on the language basis of dyslexia from historical and theoretical perspectives with a special emphasis on the relation between dyslexia and DLD and on the development of broader language skills (e.g., vocabulary, syntax, and discourse) before and after the identification of dyslexia. Results: We present clinically relevant information on the history …

Large-Scale Social And Behavior Change Communication Interventions Have Sustained Impacts On Infant And Young Child Feeding Knowledge And Practices: Results Of A 2-Year Follow-Up Study In Bangladesh, Sunny S. Kim, Phuong Hong Nguyen, Lan Mai Tran, Tina Sanghvi, Zeba Mahmud, Mohammad Raisul Haque, Kaosar Afsana, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Background: Sustained improvements in infant and young child feeding (IYCF) require continued implementation of effective interventions. From 2010-2014, Alive & Thrive (A&T) provided intensive interpersonal counseling (IPC), community mobilization (CM), and mass media (MM) in Bangladesh, demonstrating impact on IYCF practices. Since 2014, implementation has been continued and scaled up by national partners with support from other donors and with modifications such as added focus on maternal nutrition and reduced program intensity. Objective: We assessed changes in intervention exposure and IYCF knowledge and practices in the intensive (IPC + CM + MM) compared with nonintensive areas (standard nutrition counseling + …

The Effect Of E-Book Vocabulary Instruction On Spanish-English Speaking Children, Carla Wood, Lisa Fitton, Yaacov Petscher, Estrella Rodriguez, Gretchen Sunderman, Taehyeong Lim

Faculty Publications

Purpose: This study aimed to examine the effect of an intensive vocabulary intervention embedded in e-books on the vocabulary skills of young Spanish-English speaking English learners (ELs) from low-socioeconomic status backgrounds. Method: Children (N = 288) in kindergarten and 1st grade were randomly assigned to treatment and read-only conditions. All children received e-book readings approximately 3 times a week for 10-20 weeks using the same books. Children in the treatment condition received e-books supplemented with vocabulary instruction that included scaffolding through explanations in Spanish, repetition in English, checks for understanding, and highlighted morphology. Results: There was a main effect of …

Engagement Of Husbands In A Maternal Nutrition Program Substantially Contributed To Greater Intake Of Micronutrient Supplements And Dietary Diversity During Pregnancy: Results Of A Cluster-Randomized Program Evaluation In Bangladesh, Phuong Hong Nguyen, Edward A. Frongillo Jr., Tina Sanghvi, Gargi Wable, Zeba Mahmud, Lan Mai Tran, Bachera Aktar, Kaosar Afsana, Silvia Alayon, Marie T. Ruel, Purnima Menon

Faculty Publications

Background:

Although husbands may provide support during pregnancy, limited evidence exists on how to promote husbands' engagement and what impact it has. Alive & Thrive integrated nutrition-focused interventions, targeting both wives and husbands, through an existing Maternal, Neonatal, and Child Health (MNCH) platform in Bangladesh.

Objectives:

We evaluated 1) the impact of a nutrition-focused MNCH program, compared with the standard MNCH program, on husbands' behavioral determinants (i.e., awareness, knowledge, self-efficacy) and support to wives to adopt optimal nutrition practices and 2) how much of the previously documented impact on women's supplement intake and dietary diversity was explained by husbands' behavioral …

Cohort Profile: The Maternal And Infant Nutrition Interventions In Matlab (Minimat) Cohort In Bangladesh, Shams El Arifeen, Eva-Charlotte Ekström, Edward A. Frongillo Jr., Jena Hamadani, Ashraful I. Khan, Ruchira T. Naved, Anisur Rahman, Rubhana Raqib, Kathleen M. Rasmussen, Katarina Ekholm Selling, Yukiko Wagatsuma, Lars Åke Persson

Faculty Publications

No abstract provided.

Dietary Diversity Predicts The Adequacy Of Micronutrient Intake In Pregnant Adolescent Girls And Women In Bangladesh, But Use Of The 5-Group Cutoff Poorly Identifies Individuals With Inadequate Intake, Phuong Hong Nguyen, Lieven Huybregts, Tina G. Sanghvi, Lan Mai Tran, Edward A. Frongillo Jr., Purnima Menon, Marie T. Ruel

Faculty Publications

Background: The Minimum Dietary Diversity for Women (MDD-W) indicator based on a 10-food group women dietary diversity score (WDDS-10) has been validated to assess dietary quality in nonpregnant women. Little is known about its applicability in pregnant women, and specifically pregnant adolescent girls with higher nutrient requirements. Objectives: This study aimed to 1) compare the adequacy of micronutrient intakes between pregnant adolescent girls and women, 2) examine the performance of WDDS-10 in predicting the mean probability of adequacy (MPA) of 11 micronutrients, and 3) assess how well the MDD-W cutoff of 5 groups performed in pregnant adolescent girls and women. …

Can Integrated Interventions Create The Conditions That Support Caregiving For Better Child Growth?, Purnima Menon, Edward A. Frongillo Jr.

Faculty Publications

No abstract provided.

Blood Pressure Self-Monitoring In Pregnancy: Examining Feasibility In A Prospective Cohort Study, Katherine L. Tucker, Kathryn S. Taylor, Carole Crawford, James A. Hodgkinson, Clare Bankhead, Tricia Carver, Elizabeth Ewers, Margaret Glogowska, Sheila M. Greenfield, Lucy Annang Ingram Phd, Lisa Hinton, Khalid S. Khan, Louise Locock, Lucy Mackillop, Christine Mccourt, Alexander M. Pirie, Richard Stevens, Richard J. Mcmanus

Faculty Publications

BACKGROUND: Raised blood pressure (BP) affects approximately 10% of pregnancies worldwide, and a high proportion of affected women develop pre-eclampsia. This study aimed to evaluate the feasibility of self-monitoring of BP in pregnancy in women at higher risk of pre-eclampsia. METHODS: This prospective cohort study of self-monitoring BP in pregnancy was carried out in two hospital trusts in Birmingham and Oxford and thirteen primary care practices in Oxfordshire. Eligible women were those defined by the UK National Institute for Health and Care Excellence (NICE) guidelines as at higher risk of pre-eclampsia. A total of 201 participants were recruited between 12 …

Integrating Nutrition Interventions Into An Existing Maternal, Neonatal, And Child Health Program Increased Maternal Dietary Diversity, Micronutrient Intake, And Exclusive Breastfeeding Practices In Bangladesh: Results Of A Cluster-Randomized Program Evaluation, Phuong Hong Nguyen, Sunny S. Kim, Tina Sanghvi, Zeba Mahmud, Lan Mai Tran, Sadia Shabnam, Bachera Aktar, Raisul Haque, Kaosar Afsana, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Maternal undernutrition is a major concern globally, contributing to poor birth outcomes. Limited evidence exists on delivering multiple interventions for maternal nutrition simultaneously. Alive & Thrive addressed this gap by integrating nutrition-focused interpersonal counseling, community mobilization, distribution of free micronutrient supplements, and weight-gain monitoring through an existing Maternal, Neonatal, and Child Health (MNCH) program in Bangladesh. We evaluated the effect of providing nutrition-focused MNCH compared with standard MNCH (antenatal care with standard nutrition counseling) on coverage of nutrition interventions, maternal dietary diversity, micronutrient supplement intake, and early breastfeeding practices. We used a cluster-randomized design with cross-sectional surveys at baseline (2015) …

Application Of Fluoroquinolone Resistance Score In Management Of Complicated Urinary Tract Infections, Ansal Shah, Julie Ann Justo, P Brandon Bookstaver, Joseph Kohn, Helmut Albrecht, Majdi N. Al-Hasan

Faculty Publications

The fluoroquinolone resistance score (FQRS) predicts the probability of fluoroquinolone resistance with good discrimination. The score has been derived from patients with bloodstream infections caused by Gram-negative bacteria and is based on fluoroquinolone use within the past 6 months, among other clinical and health care exposure criteria. This study aims to examine the utility of the FQRS in patients with complicated urinary tract infections (cUTI) and determine whether extension of prior fluoroquinolone use to 12 months improves model discrimination. Adults with cUTI at Palmetto Health in central South Carolina, USA, from 1 April 2015 through 31 July 2015 were prospectively …

Social Franchising And A Nationwide Mass Media Campaign Increased The Prevalence Of Adequate Complementary Feeding In Vietnam: A Cluster-Randomized Program Evaluation, Rahul Rawat, Phuong Hong Nguyen, Lan Mai Tran, Nemat Hajeebhoy, Huan Van Nguyen, Jean Baker, Edward A. Frongillo Jr., Marie T. Ruel, Purnima Menon

Faculty Publications

Rigorous evaluations of health system-based interventions in large-scale programs to improve complementary feeding (CF) practices are limited. Alive & Thrive applied principles of social franchising within the government health system in Vietnam to improve the quality of interpersonal counseling (IPC) for infant and young child feeding combined with a national mass media (MM) campaign and community mobilization (CM). We evaluated the impact of enhanced IPC + MM + CM (intensive) compared with standard IPC + less-intensive MM and CM (nonintensive) on CF practices and anthropometric indicators. A cluster-randomized, nonblinded evaluation design with cross-sectional surveys ( = ∼500 children aged 6-23.9 …

Changes In Underlying Determinants Explain Rapid Increases In Child Linear Growth In Alive & Thrive Study Areas Between 2010 And 2014 In Bangladesh And Vietnam, Phuong Hong Nguyen, Derek Headey, Edward A. Frongillo Jr., Lan Mai Tran, Rahul Rawat, Marie T. Ruel, Purnima Menon

Faculty Publications

Background: Child linear growth sometimes improves in both intervention and comparison groups in evaluations of nutrition interventions, possibly because of spillover intervention effects to nonintervention areas or improvements in underlying determinants of nutritional change in both areas.

Objective: We aimed to understand what changes in underlying socioeconomic characteristics and behavioral factors are important in explaining improvements in child linear growth.

Methods: Baseline (2010) and endline (2014) surveys from the Alive & Thrive impact evaluation were used to identify the underlying determinants of height-for-age z scores (HAZs) among children aged 24–48 mo in Bangladesh (n = 4311) and 24–59 mo …

Inhibition Of Cdk8 Mediator Kinase Suppresses Estrogen Dependent Transcription And The Growth Of Estrogen Receptor Positive Breast Cancer, Martina S. Mcdermott, Alexander A. Chumanevich, Chang-Uk Lim, Jiaxin Liang, Mengqian Chen, Serena Altilia, David Oliver, James M. Rae, Michael Shtutman, Hippokratis Kiaris, Balázs Győrffy, Igor Roninson, Eugenia Broude

Faculty Publications

Hormone therapy targeting estrogen receptor (ER) is the principal treatment for ER-positive breast cancers. However, many cancers develop resistance to hormone therapy while retaining ER expression. Identifying new druggable mediators of ER function can help to increase the efficacy of ER-targeting drugs. Cyclin-dependent kinase 8 (CDK8) is a Mediator complex-associated transcriptional regulator with oncogenic activities. Expression of CDK8, its paralog CDK19 and their binding partner Cyclin C are negative prognostic markers in breast cancer. Meta-analysis of transcriptome databases revealed an inverse correlation between CDK8 and ERα expression, suggesting that CDK8 could be functionally associated with ER. We have found that …

Large-Scale Behavior-Change Initiative For Infant And Young Child Feeding Advanced Language And Motor Development In A Cluster-Randomized Program Evaluation In Bangladesh, Edward A. Frongillo Jr., Phuong H. Nguyen, Kuntal K. Saha, Tina Sanghvi, Kaosar Afsana, Raisul Haque, Jean Baker, Marie T. Ruel, Rahul Rawat, Purnima Menon

Faculty Publications

Background: Promoting adequate nutrition through interventions to improve infant and young child feeding (IYCF) has the potential to contribute to child development.

Objective: We examined whether an intensive intervention package that was aimed at improving IYCF at scale through the Alive & Thrive initiative in Bangladesh also advanced language and gross motor development, and whether advancements in language and gross motor development were explained through improved complementary feeding.

Methods: A cluster-randomized design compared 2 intervention packages: intensive interpersonal counseling on IYCF, mass media campaign, and community mobilization (intensive) compared with usual nutrition counseling and mass media campaign (nonintensive). Twenty subdistricts …

Variation In Type And Frequency Of Diagnostic Imaging During Trauma Care Across Multiple Time Points By Patient Insurance Type, Nathaniel Bell, Laura Repáraz, William R. Fry, R Stephen Smith, Alejandro Luis

Faculty Publications

BACKGROUND:

Research has shown that uninsured patients receive fewer radiographic studies during trauma care, but less is known as to whether differences in care are present among other insurance groups or across different time points during hospitalization. Our objective was to examine the number of radiographic studies administered to a cohort of trauma patients over the entire hospital stay as well as during the first 24-hours of care.

METHODS:

Patient data were obtained from an American College of Surgeons (ACS) verified Level I Trauma Center between January 1, 2011 and December 31, 2012. We used negative binomial regression to construct …

Infant Formula Feeding At Birth Is Common And Inversely Associated With Subsequent Breastfeeding Behavior In Vietnam, Tuan T. Nguyen, Mellissa Withers, Nemat Hajeebhoy, Edward A. Frongillo

Faculty Publications

BACKGROUND: The association between infant formula feeding at birth and subsequent feeding patterns in a low- or middle-income context is not clear. OBJECTIVE: We examined the association of infant formula feeding during the first 3 d after birth with subsequent infant formula feeding and early breastfeeding cessation in Vietnam. METHODS: In a cross-sectional survey, we interviewed 10,681 mothers with children aged 0-23 mo (mean age: 8.2 mo; 52% boys) about their feeding practices during the first 3 d after birth and on the previous day. We used stratified analysis, multiple logistic regression, propensity score-matching analysis, and structural equation modeling to …

Combining Intensive Counseling By Frontline Workers With A Nationwide Mass Media Campaign Has Large Differential Impacts On Complementary Feeding Practices But Not On Child Growth: Results Of A Cluster-Randomized Program Evaluation In Bangladesh, Purnima Menon, Phuong Hong Nguyen, Kuntal Kumar Saha, Adiba Khaled, Tina Sanghvi, Jean Baker, Kaosar Afsana, Raisul Haque, Edward A. Frongillo Jr., Marie T. Ruel, Rahul Rawat

Faculty Publications

Background: Complementary feeding (CF) contributes to child growth and development, but few CF programs are delivered at scale. Alive & Thrive addressed this in Bangladesh through intensified interpersonal counseling (IPC), mass media (MM), and community mobilization (CM).

Objective: The objective was to evaluate the impact of providing IPC + MM + CM (intensive) compared with standard nutrition counseling + less intensive MM + CM (nonintensive) on CF practices and anthropometric measurements.

Methods: We used a cluster-randomized, nonblinded evaluation with cross-sectional surveys [n = ∼600 and 1090 children 6-23.9 mo and 24-47.9 mo/group, respectively, at baseline (2010) and n = ∼500 …

Effect Of A Randomised Exclusive Breastfeeding Counselling Intervention Nested Into The Minimat Prenatal Nutrition Trial In Bangladesh, Ashraful Islam Khan, Iqbal Kabir, Hanna Eneroth, Shams El Arifeen, Eva-Charlotte Ekström, Edward A. Frongillo Jr., Lars Åke Persson

Faculty Publications

AIM: It is unknown whether maternal malnutrition reduces the effect of counselling on exclusive breastfeeding. This study evaluated the effect of breastfeeding counselling on the duration of exclusive breastfeeding, and whether the timing of prenatal food and different micronutrient supplements further prolonged this duration. METHODS: Pregnant women in Matlab, Bangladesh, were randomised to receive daily food supplements of 600 kcal at nine weeks of gestation or at the standard 20 weeks. They also were allocated to either 30 mg of iron and 400 μg folic acid, or the standard programme 60 mg of iron and folic acid or multiple micronutrients. …

A Technology-Mediated Behavioral Weight Gain Prevention Intervention For College Students: Controlled, Quasi-Experimental Study, Delia Smith West, Courtney M. Monroe, Gabrielle Turner-Mcgrievy, Beth Sundstrom, Chelsea Larsen, Karen Magradey, Sara Wilcox, Heather M. Brandt

Faculty Publications

BACKGROUND: Both men and women are vulnerable to weight gain during the college years, and this phenomenon is linked to an increased risk of several chronic diseases and mortality. Technology represents an attractive medium for the delivery of weight control interventions focused on college students, given its reach and appeal among this population. However, few technology-mediated weight gain prevention interventions have been evaluated for college students. OBJECTIVE: This study examined a new technology-based, social media-facilitated weight gain prevention intervention for college students. METHODS: Undergraduates (n =58) in two sections of a public university course were allocated to either a behavioral …

Progress In Improving Provincial Plans For Nutrition Through Targeted Technical Assistance And Local Advocacy In Vietnam, Jody Harris, Phuong H. Nguyen, Quyen To, Edward A. Frongillo Jr., Purnima Menon

Faculty Publications

Vietnam has been decentralizing nutrition planning to provinces, which could help with local relevance and accountability. Assessment in 2009 found a continuing top-down approach, limited human capacity, and difficulty in integrating multiple sectors. Alive and Thrive (A&T) provided targeted assistance and capacity-building for 15 provincial plans for nutrition (PPNs). We aimed to (i) assess PPN content and quality improvements 2009-2014, and (ii) explain processes through which change occurred. Data consisted of interview-based assessments of provincial planning processes, annual PPN assessments, and tracking of A&T involvement. At endline, some provinces produced higher quality plans. Local planning skills improved, but capacity remained …

Prediction Of Fluoroquinolone Resistance In Gram-Negative Bacteria Causing Bloodstream Infections, Seejil Dan, Ansal Shah, Julie Ann Justo, P Brandon Bookstaver, Joseph Kohn, Helmut Albrecht, Majdi N. Al-Hasan

Faculty Publications

Increasing rates of fluoroquinolone resistance (FQ-R) have limited empirical treatment options for Gram-negative infections, particularly in patients with severe beta-lactam allergy. This case-control study aims to develop a clinical risk score to predict the probability of FQ-R in Gram-negative bloodstream isolates. Adult patients with Gram-negative bloodstream infections (BSI) hospitalized at Palmetto Health System in Columbia, South Carolina, from 2010 to 2013 were identified. Multivariate logistic regression was used to identify independent risk factors for FQ-R. Point allocation in the fluoroquinolone resistance score (FQRS) was based on regression coefficients. Model discrimination was assessed by the area under receiver operating characteristic curve …

Successive 1-Month Weight Increments In Infancy Can Be Used To Screen For Faltering Linear Growth, Adelheid W. Onyango, Elaine Borghi, Mercedes De Onis, Edward A. Frongillo Jr., Cesar G. Victora, Kathryn G. Dewey, Anna Lartey, Nita Bhandari, Anne Baerug, Cutberto Garza

Faculty Publications

Background: Linear growth faltering in the first 2 y contributes greatly to a high stunting burden, and prevention is hampered by the limited capacity in primary health care for timely screening and intervention.

Objective: This study aimed to determine an approach to predicting long-term stunting from consecutive 1-mo weight increments in the first year of life.

Methods: By using the reference sample of the WHO velocity standards, the analysis explored patterns of consecutive monthly weight increments among healthy infants. Four candidate screening thresholds of successive increments that could predict stunting were considered, and one was selected for …

Dissemination Of An Electronic Manual To Build Capacity For Implementing Farmers’ Markets With Community Health Centers, M Aaron Guest, Darcy Freedman, Kassandra A. Alia, Heather M. Brandt, Daniela B. Friedman

Faculty Publications

Community-university partnerships can lend themselves to the development of tools that encourage and promote future community health development. The electronic manual, "Building Farmacies," describes an approach for developing capacity and sustaining a community health center-based farmers' market that emerged through a community-university partnership. Manual development was guided by the Knowledge to Action Framework and experiences developing a multivendor, produce-only farmers' market at a community health center in rural South Carolina. The manual was created to illustrate an innovative solution for community health development. The manual was disseminated electronically through 25 listservs and interested individuals voluntarily completed a Web-based survey to …

Federally Qualified Health Centers’ Capacity And Readiness For Research Collaborations: Implications For Clinical-Academic-Community Partnerships, Heather M. Brandt, Vicki M. Young, Dayna A. Campbell, Seul Ki Choi, Jessica S. Seel, Daniela B. Friedman

Faculty Publications

BACKGROUND: Federally qualified health centers (FQHCs) provide a health care safety net for underserved populations and contribute unique expertise to research that could further enhance quality of patient care. The purpose of this research was to assess interest in, readiness to, and capacity for conducting research in FQHCs in South Carolina (SC). METHODS: A Web-based survey was administered to 20 FQHCs across SC. Fourteen representatives of FQHCs completed the 39-item survey that assessed research experience and interest, partnerships and funding, barriers and benefits to research participation, training and technical assistance needs, and research capacity. RESULTS: FQHCs are interested in conducting …

Census-Based Socioeconomic Indicators For Monitoring Injury Causes In The Usa: A Review, Nathaniel Bell, Amanda Arrington, Swann Arp Adams

Faculty Publications

BACKGROUND:

Unlike the UK or New Zealand, there is no standard set of census variables in the USA for characterising socioeconomic (SES, socioeconomic status) inequalities in health outcomes, including injury. We systematically reviewed existing US studies to identify conceptual and methodological strengths and limitations of current approaches to determine those most suitable for research and surveillance.

METHODS:

We searched seven electronic databases to identify census variables proposed in the peer-reviewed literature to monitor injury risk. Inclusion criteria were that numerator data were derived from hospital, trauma or vital statistics registries and that exposure variables included census SES constructs.

RESULTS:

From …

Identification Of Novel Genes That Regulate Androgen Receptor Signaling And Growth Of Androgen-Deprived Prostate Cancer Cells, Elina Levina, Hao Ji, Mengqiang Chen, Mirza Baig, David Oliver, Patrice Ohouo, Chang-Uk Lim, Garry Schools, Steven Carmack, Ye Ding, Eugenia Broude, Igor Roninson, Ralph Buttyan, Michael Shtutman

Faculty Publications

Prostate cancer progression to castration refractory disease is associated with anomalous transcriptional activity of the androgen receptor (AR) in an androgen-depleted milieu. To identify novel gene products whose downregulation transactivates AR in prostate cancer cells, we performed a screen of enzymatically-generated shRNA lenti-libraries selecting for transduced LNCaP cells with elevated expression of a fluorescent reporter gene under the control of an AR-responsive promoter. The shRNAs present in selected populations were analyzed using high-throughput sequencing to identify target genes. Highly enriched gene targets were then validated with siRNAs against selected genes, testing first for increased expression of luciferase from an AR-responsive …

Stratification Of The Impact Of Inappropriate Empirical Antimicrobial Therapy For Gram-Negative Bloodstream Infections By Predicted Prognosis, Sarah E. Cain, Joseph Kohn, P. Brandon Bookstaver, Helmut Albrecht, Majdi N. Al-Hasan

Faculty Publications

The bloodstream infection mortality risk score (BSIMRS) predicts the outcome of patients with Gram-negative bloodstream infections (BSI) with high discrimination. This retrospective cohort study examined the impact of inappropriate antimicrobial therapy on mortality in adult patients with Gram-negative BSI admitted to Palmetto Health Hospitals in Columbia, SC, USA, from 1 January 2011 to 31 December 2012 after stratification by predicted prognosis at initial presentation using BSIMRS. A multivariate Cox regression model was used to identify independent risk factors for 28-day mortality overall and within each predefined BSIMRS category (<5, 5 to 9, and ≥10). Relative risk reduction (RRR), absolute risk reduction (ARR), and number needed to treat (NNT) were calculated from a predictive logistic regression model of mortality. Overall, 390 unique patients with first episodes of Gram-negative BSI were identified. The median age was 66 years, and 229 (59%) were women. There was significant association between inappropriate antimicrobial therapy and mortality in patients with BSIMRS of 5 to 9 (adjusted hazard ratio [aHR], 3.55; 95% confidence intervals [CI], 1.22 to 8.31; P = 0.02) and BSIMRS of ≥10 (aHR, 4.99; 95% CI, 1.09 to 22.87; P = 0.04) but not in those with BSIMRS of <5 (aHR, 3.34; 95% CI, 0.17 to 22.77; P = 0.34). RRR, ARR, and NNT were 0.25, 0.02, and 63 for BSIMRS of <5; 0.56, 0.32, and 3 for BSIMRS of 5 to 9; and 0.39, 0.39, and 3 for BSIMRS of ≥10, respectively. There is a significant benefit from appropriate antimicrobial therapy in patients with Gram-negative BSI with guarded (BSIMRS of 5 to 9) and poor (BSIMRS of ≥10) predicted prognosis. Survival difference remains unclear among those with good predicted prognosis (BSIMRS of <5) at initial presentation.

Musculoskeletal Safety Outcomes Of Patients Receiving Daptomycin With Hmg-Coa Reductase Inhibitors, Christopher M. Bland, P Brandon Bookstaver, Z Kevin Lu, Brianne L. Dunn, Kathey Fulton Rumley

Faculty Publications

Daptomycin, a cyclic lipopeptide antibiotic, and 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) are commonly administered in the inpatient setting and are associated with creatine phosphokinase (CPK) elevations, myalgias, and muscle weakness. Safety data for coadministration of daptomycin with statins are limited. To determine the safety of coadministration of daptomycin with statin therapy, a multicenter, retrospective, observational study was performed at 13 institutions in the Southeastern United States. Forty-nine adult patients receiving statins concurrently with daptomycin were compared with 171 patients receiving daptomycin without statin therapy. Detailed information, including treatment indication and duration, infecting pathogen, baseline and subsequent CPK levels, and …

Predictors Of Healthcare Professionals’ Attitudes Towards Family Involvement In Safety-Relevant Behaviours: A Cross-Sectional Factorial Survey Study, Rachel Davis, M Savvopoulou, R Shergill, S Shergill, D Schwappach

Faculty Publications

OBJECTIVES: To investigate predictors of healthcare professionals' (HCPs) attitudes towards family involvement in safety-relevant behaviours. DESIGN: A cross-sectional fractional factorial survey that assessed HCPs' attitudes towards family involvement in two error scenarios relating to hand hygiene and medication safety. Each survey comprised two randomised vignettes that described the potential error, how the family member communicated with the HCP about the error and how the HCP responded to the family member's question. SETTING: 5 teaching hospitals in London, the Midlands and York. HCPs were approached on a range of medical and surgical wards. PARTICIPANTS: 160 HCPs (73 doctors; 87 nurses) aged …