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Culture Care Needs Of Puerto Rican Women Receiving Hiv Care From Nurse Practitioners In New York City, Michele Crespo-Fierro

Dissertations, Theses, and Capstone Projects

The purpose of this mini-ethnonursing research study was to discover, describe, and interpret culture care values, beliefs, expressions, practices and needs of Puerto Rican women receiving HIV care from nurse practitioners (NPs) and other providers in New York City. The emic, or insider, perspective of Puerto Rican women living with HIV was the focus of this study and Leininger’s Culture Care Theory (CCT) provided the theoretical framework. Various enablers of the CCT, including Leininger’s Sunrise Enabler to Discover Culture Care, guided the design andimplementation of the study. Six key and twelve general informantswere interviewed and data from the interviews were …

Predicting Risk Of Hospitalisation: A Retrospective Population-Based Analysis In A Paediatric Population In Emilia-Romagna, Italy., Daniel Z. Louis, Clara A. Callahan, Mary Robeson, Mengdan Liu, Jacquelyn Mcrae, Joseph S. Gonnella, Marco Lombardi, Vittorio Maio

College of Population Health Faculty Papers

OBJECTIVES: Develop predictive models for a paediatric population that provide information for paediatricians and health authorities to identify children at risk of hospitalisation for conditions that may be impacted through improved patient care.

DESIGN: Retrospective healthcare utilisation analysis with multivariable logistic regression models.

DATA: Demographic information linked with utilisation of health services in the years 2006-2014 was used to predict risk of hospitalisation or death in 2015 using a longitudinal administrative database of 527 458 children aged 1-13 years residing in the Regione Emilia-Romagna (RER), Italy, in 2014.

OUTCOME MEASURES: Models designed to predict risk of hospitalisation or death in …

Herpes Zoster Patient Education: A Coloring Book Approach, Sophia Charuhas

Senior Honors Theses

Shingles, the disease caused by the herpes zoster virus, is a widespread and widely misunderstood illness in the United States. It is preventable, but many at-risk patients do not know what measures they may take to prevent it. Clear communication from physician to patient is crucial for patient understanding of diseases. Many patient education materials on herpes zoster currently available are often unused. It is therefore beneficial to public health to disseminate new mediums of medical communication, and one way of accomplishing this is through adult coloring books. The pathophysiology of herpes zoster virus is here explored and the idea …

Use Of Urine Antigen Testing For Blastomyces In An Integrated Health System, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Purpose: Blastomycosis, an endemic fungal infection, mimics many other diseases. We explored the use of Blastomyces urine antigen (BuAg), reportedly the most sensitive noninvasive test, in clinical practice and compared it to other noninvasive tests.

Methods: A total of 836 BuAg tests performed on unique patients (first test only) at one large integrated health system from June 2013 to May 2016 were retrospectively reviewed to examine test characteristics and demographic features. Of these, 100 cases from 2015, a year containing a large local blastomycosis outbreak, were randomly selected for detailed analysis.

Results: Demographics for the BuAg-tested population: mean age 54.9 …

Identification Of Novel Hits Against, Ala A. Azhari

USF Tampa Graduate Theses and Dissertations

Leishmaniasis is a disease caused by obligate intracellular parasites of the genus Leishmania, including 20 species that are pathogenic to humans. Female sand fly is the known vector that can transmit the disease. Visceral leishmaniasis is the severe form of the disease that affects internal organs and can be fatal with inappropriate diagnosis or treatment. Leishmania donovani is the causative agent of visceral leishmaniasis. Approximately 350 million in 89 countries are at risk of infection. Around 2 million new cases are reported annually with 500,000 of these are visceral leishmaniasis. Current drug therapies are inadequate due to their toxicity, high …

Recovering Parasites From Mummies And Coprolites: An Epidemiological Approach, Morgana Camacho, Adauto Araújo, Johnica J. Morrow, Jane E. Buikstra, Karl Reinhard

Karl Reinhard Publications

In the field of archaeological parasitology, researchers have long documented the distribution of parasites in archaeological time and space through the analysis of coprolites and human remains. This area of research defined the origin and migration of parasites through presence/absence studies. By the end of the 20th century, the field of pathoecology had emerged as researchers developed an interest in the ancient ecology of parasite transmission. Supporting studies were conducted to establish the relationships between parasites and humans, including cultural, subsistence, and ecological reconstructions. Parasite prevalence data were collected to infer the impact of parasitism on human health. In the …

The Medical Evaluation Of The Newly Resettled Female Refugee: A Narrative Review, Anne Duckles, Aba Barden-Maja, Julie Caplow

Journal of Refugee & Global Health

The number of forcibly displaced individuals worldwide is increasing each year, reaching 65 million persons by the end of 2015, half of which were women and children. As the population of displaced persons grows, it is every physician’s responsibility to understand these patients and their health needs. Refugee patients and the providers who care for them face many barriers to effective patient care, including language barriers, cultural differences, and systematic inequalities. Female refugees commonly experience gender-based violence, repetitive trauma, stigmatized mental illness, and cultural barriers to women’s healthcare. This review is intended to be a comprehensive guide for the provider …

A Mini Review Of The Zoonotic Threat Potential Of Influenza Viruses, Coronaviruses, Adenoviruses, And Enteroviruses, E. S. Bailey, J. K. Fieldhouse, J. Y. Choi, G. C. Gray

Public Health

No abstract provided.

Adult Patients Living With Human Immunodeficiency Virus Hospitalized For Community-Acquired Pneumonia In The United States: Incidence And Outcomes, Leslie A. Beavin, Stephen P. Furmanek, Paula Peyrani, Anupama Raghuram, Forest W. Arnold, Mark Burns, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Background: Community-acquired pneumonia (CAP) is a common infectious reason for hospitalization of adults in the United States (US), including those with Human Immunodeficiency Virus (HIV). While there are studies detailing the incidence and outcomes for all adults with CAP we are not aware of a recent study detailing incidence and outcomes in adult HIV patients hospitalized with CAP. The objectives of this study were (1) to define the current incidence and outcomes of adult HIV patients hospitalized with CAP in Louisville, Kentucky, and (2) to estimate the burden of CAP in the US HIV adult population.

Methods: This was a …

Bacteremic Pneumococcal Pneumonia: A Longitudinal Study In 279 Adult Patients From A Single Center, Jorge H. Gentile, Claudia Hernandez, Monica D. Sparo, Edgardo M. Rodriguez, Carolina Ceriani, Florencia Bruggesser

The University of Louisville Journal of Respiratory Infections

Background: Bacteremic pneumococcal pneumonia (BPP) is the most common clinical presentation of invasive pneumococcal disease (IPD). Although it has been extensively studied, there is little knowledge in our region in relation to burden of disease, demographic and outcome features.

Methods: We conducted a prospective, longitudinal, observational study from 1989 to 2015 in adult patients with BPP, in order to deepen our knowledge of the characteristics of this disease in our community hospital in Tandil, Argentina.

Results: 279 patients were included. The mean incidence was 2.8/1000 admissions with a sharp decrease in the last two years, reaching 0.8/1000 admissions. Mean patient …

Real-Time Pcr Detection Of Mycoplasma Pneumoniae, Chlamydia Pneumoniae And Legionella Pneumophila In Respiratory Specimens Using The Aries® System, Subathra Marimuthu, Leslie A. Wolf, James T. Summersgill

The University of Louisville Journal of Respiratory Infections

Background: Mycoplasma pneumoniae (Mpn), Chlamydia pneumoniae (Cpn), and Legionella pneumophila (Lpn) can cause both epidemic and endemic occurrences of acute respiratory disease and are responsible for up to 22% of cases of community acquired pneumonia. Due to the limited availability of FDA-approved molecular diagnostic assays, we developed and evaluated a multiplexed Real-time PCR assay for the detection of these agents in two respiratory specimen types on the Luminex ARIES® instrument. The instrument provides for nucleic acid extraction plus PCR amplification and target detection in the same cassette. The ARIES® instrument generates a cycle threshold value and a confirmatory melt curve …

Mycobacterium Kansasii As The Primary Etiology Of Pulmonary Infections Due To Non-Tuberculous Mycobacterium (Ntm) In Patients Without Human Immunodeficiency Virus (Hiv): Experience From A Center In Buenos Aires, Argentina, Gabriel Yusti, Marcela Heres, Alejandra González, Mariano Fielli, Adrian Ceccato, Alejandra Zapata

The University of Louisville Journal of Respiratory Infections

Introduction: Pulmonary diseases due to non-tuberculous mycobacterium (NTM) lung infection in HIV-negative patients are rarely described in the literature. Currently, NTM consist of more than 150 species, and they are globally ubiquitous in both natural and man-made environments.The objective of this study was to define the most frequent species of NTM causing pulmonary disease in HIV-negative patients in the city of Buenos Aires, Argentina. The prevalence of pulmonary diseases caused by NTM is difficult to determine since the isolation of NTM does not necessarily indicate disease.

Methods: A retrospective review of all the respiratory cultures positive for NTM in the …

A Software Tool For Automated Upload Of Large Clinical Datasets Using Redcap And The Capo Database, William A. Mattingly, Christopher Sinclair, Danna Williams, Matthew Grassman, Stephen Furmanek, Kimberley Buckner, Mohammad Tahboub

The University of Louisville Journal of Respiratory Infections

Introduction: Obtaining clinical data from healthcare sources is necessary for conducting clinical research. New technologies now allow for connecting a research database to Electronic Medical Records remotely, allowing the automatic import of clinical research data. In this paper we design and evaluate a REDCap extension to import clinical records from an external health database.

Methods: Many hospital EHRs are designed to use secure file transfer protocol (SFTP) repositories for data communication. We develop a REDCap plugin to connect to an external SFTP file repository for the import of clinical record data. We use the CAPO instance of REDCap and a …

Effectiveness Of The Influenza Vaccine In Preventing Hospitalizations Of Patients With Influenza Community-Acquired Pneumonia, Thomas Chandler, Stephen P. Furmanek, Connor L. English, Connor Glick, Wesley Trail, Lara Daniels, Ugochukwu Owolabi, Ruth Carrico, Julio A. Ramirez, Timothy L. Wiemken

The University of Louisville Journal of Respiratory Infections

Introduction: Influenza vaccination is the primary strategy for prevention of influenza infection. Influenza infection can vary from mild or even asymptomatic illness to severe community-acquired pneumonia (CAP). Although many national and international investigators and organizations report annual estimates of influenza vaccine effectiveness for prevention of influenza infection in the community, few studies report estimates for the prevention of hospitalizations due to influenza CAP, the most severe form of the infection. The objective of this study is to determine the effectiveness of the influenza vaccine for prevention of hospitalization in patients with influenza-associated CAP.

Methods: This was a test-negative study using …

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, The Clinical Research Coordinating Center Team

The University of Louisville Journal of Respiratory Infections

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Non-Resolving Community Acquired Pneumonia (Cap) Due To Blastomyces Dermatitidis (Pulmonary Blastomycosis): Case Report And Review Of Literature, Johnson Britto

The University of Louisville Journal of Respiratory Infections

In this case report, we describe a case of progressive acute pulmonary blastomycosis in a healthy adult living in Kentucky, initially presenting with flu like illness with a left sided consolidation, who did not respond to antibiotic therapy. Patient’s clinical condition deteriorated with development of necrotizing bronchopneumonia, mediastinal lymphadenopathy, tree-in-bud reticulonodularity and pleural effusion. A diagnosis of progressive pulmonary blastomycosis was established by radiological findings as well as transbronchial needle aspiration cytology and bronchoalveolar lavage culture demonstrating Blastomyces dermatitidis. Patient showed significant clinical improvement with resolution of pulmonary lesions on antifungal treatment. Since symptoms of blastomycosis are often similar to …

An Hiv-Positive Patient With Copd Admitted To The Icu With Respiratory Failure, Bhavani Puskur, Veronica Corcino, Srikant Ramachandruni, Viswanathan Nagarajan, Forest W. Arnold

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Duration Of Antibiotic Therapy For Patients With Bacteremic Staphylococcus Aureus Community-Acquired Pneumonia, Julio A. Ramirez, Thomas File, Daniel Musher

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Geospatial Inequalities And Determinants Of Nutritional Status Among Women And Children In Afghanistan: An Observational Study, Nadia Akseer, Zaid Ahmad Bhatti, Taufiq Mashal, Sajid Bashir Soofi, Rahim Moineddin, Robert E Black Md, Zulfiqar Ahmed Bhutta

Department of Paediatrics and Child Health

Background: Undernutrition is a pervasive condition in Afghanistan, and prevalence is among the highest in the world. We aimed to comprehensively assess district-level geographical disparities and determinants of nutritional status (stunting, wasting, or underweight) among women and children in Afghanistan.
Methods: The study used individualised data from the recent Afghanistan National Nutrition Survey 2013. Outcome variables were based on growth and weight anthropometry data, which we analysed linearly as Z scores and as dichotomous categories. We analysed data from a total of almost 14 000 index mother–child pairs using Bayesian spatial and generalised least squares regression models accounting for the …

Communication Between Clinicians And The Hospital-Based Microbiology Laboratory: Strategies For 2018 And Beyond, Hans H. Liu

The University of Louisville Journal of Respiratory Infections

No abstract provided.

Clinical Research: From Idea To Publication, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

Julio A. Ramirez, M.D., FACP, Professor of Medicine/Associate Professor of Microbiology and Immunology; Chief, Division of Infectious Diseases; Director, Infectious Diseases Fellowship Training Program and Founding Director, Global Health Initiative at The University of Louisville, presented "Clinical Research: From Idea to Publication" at University of Louisville Department of Medicine Grand Rounds on February 15, 2018. The talk focused on performing an overview of clinical study designs, describing the planning and performing of a clinical study, reviewing the process for statistical and clinical analysis, and presenting the structure of a Clinical Research Coordinating Center.

Research Support Infrastructure: Implementing A Clinical Research Coordinating Center, Julio A. Ramirez, Paula Peyrani, William A. Mattingly, Forest W. Arnold, Timothy L. Wiemken, Robert R. Kelley, Leslie A. Wolf, Ruth M. Carrico, Andrea Reyes-Vega

Faculty and Staff Scholarship

Insufficient infrastructure is one of the challenges facing investigators in the field of clinical research. At the University of Louisville (UofL) Division of Infectious Diseases, we developed a multidisciplinary coordinating center with the aim to support investigators in all aspects of the clinical research process. The objective of this article is to describe the composition and the role of the different units of the UofL Clinical Research Coordinating Center. The different components of the Center can serve as a template for institutions interested in developing a clinical research support infrastructure.

Involuntary Sterilization Among Hiv-Positive Garifuna Women From Honduras Seeking Asylum In The United States: Two Case Reports, Holly G. Atkinson, Deborah Ottenheimer

Publications and Research

Voluntary sterilization is one of the most widely used forms of contraception by women worldwide; however, involuntary sterilization is considered a violation of multiple human rights and grounds for asylum in the United States. Women have been disproportionately affected by this practice. We report two cases of involuntary sterilization in HIV-positive Garifuna women from Honduras who sought asylum in America and were medically evaluated at the request of their attorneys. Key lessons can be drawn from these cases with regard to the importance of medical evaluations in establishing persecution. These include the need for a detailed account of the events …

Vaccine Epidemiology And Decision-Making: A Bryant Student Focus, Hannah Coburn

Honors Projects in Science and Technology

The Centers for Disease Control and Prevention estimate that influenza has resulted in between 9.2 and 35.6 million illnesses and between 12,000 and 56,000 deaths annually since 2010 (1). Annual influenza vaccination remains to be the most effective way in controlling the spread and symptom severity of influenza infections (1). Influenza infections are especially virulent on college campuses as a dense population of students interact in close quarters such as shared housing, bathrooms, dining halls, classrooms, and social activities (2). Despite influenza vaccinations being safe, effective, easily accessible to Bryant University students, and free of cost, many students choose not …

Increasing Cervical Cancer Screening In Hiv Positive Women By Introduction Of A Provider Prompted Algorithm Tool: A Quality Improvement Project, Aubri B. Hickman

Doctoral Projects

Continuous quality improvement projects and appropriate documentation are an essential component to continue to receive Ryan White grant funding. Compliance with mandated aspects of quality improvement is an extremely important concept-specifically for a clinic setting that cares for the largest HIV positive population in the state of Mississippi. The Health Resources and Services Administration (HRSA) provides directives mandating that quality improvement projects should be applicable to areas of need and provide for outcomes that ensure quality care for HIV positive individuals (2016).

Initially, this clinic’s rate of compliance with the HRSA Cervical Cancer Screening Performance Measure was subpar to the …

Shigellosis And Giardiasis Among People Living With Hiv In Washington, Dc, 2012-2016, Kimesha Linton, Kerri Dorsey, Sasha Mcgee, Preetha Iyengar, Garret Lum, Rupali Doshi

GW Research Days 2016 - 2020

Background: Shigellosis and giardiasis are transmitted via food, water, and fecal-oral contact. CDC has recently reported increased shigellosis among men who have sex with men (MSM) and among people living with HIV (PLWH), particularly stage 3. Our goal was to characterize the incidence and risk factors associated with shigellosis and giardiasis among PLWH in Washington, DC, in an era of robust availability of antiretroviral treatment.

Methods: We conducted a retrospective analysis of HIV, shigellosis and giardiasis cases reported to the District of Columbia Department of Health from 2012 to 2016. We used LinkPlus to probabilistically match individuals with reported …

Cross-Sectional Comparison Of Behavioral Risk Factors For Hiv/Hcv In People Who Inject Drugs (Pwid) In Egypt, Sarah Martinez, Amira A. Roess, Monica S. Ruiz, Atef Bakhoum, Ehab El Kharrat

GW Research Days 2016 - 2020

Background

Egypt has the greatest HCV prevalence worldwide at 15% and a concentrated HIV epidemic in male people who inject drugs (PWID) at 6.8%, who are at a high risk for HCV infection as well. Injection drug use is criminalized in Egypt, and there is limited availability of harm reduction programs. Drug-use and sexual risk behaviors between PWID and the general population have not been studied there.

Methods

To address this gap, a cross-sectional HIV/HCV epidemiological study of 632 consenting injection drug users in Cairo and Alexandria was conducted. Bivariate logistic regression analysis was done to evaluate the associations between …

Sans-Papiers, Sans-Santé: A Study Of Undocumented Migrant Women’S Access To Reproductive And Obstetric Health Care In Switzerland, Sarah Kinch

Independent Study Project (ISP) Collection

In recent years, Switzerland has seen increasing numbers of foreign-born residents, making it one of the many countries affected by the European Migrant Crisis. Of these newly-settled migrants, many live in the country illegally, otherwise known as undocumented migrants or “Sans-Papiers.” While Switzerland grants its Sans-Papiers population a right to health, thus making medical insurance and care legal for the undocumented community, many still see increased adverse health outcomes among the population. As more than half of the Sans-Papiers living in Switzerland are female, women are therefore increasingly at risk for worse reproductive and obstetric health. This study sought to …

How Much Do We Spend? Creating Historical Estimates Of Public Health Expenditures In The United States At The Federal, State, And Local Levels, Jonathon P. Leider, Beth Resnick, David Bishai, F. Douglas Scutchfield

Health Management and Policy Faculty Publications

The United States has a complex governmental public health system. Agencies at the federal, state, and local levels all contribute to the protection and promotion of the population's health. Whether the modern public health system is well situated to deliver essential public health services, however, is an open question. In some part, its readiness relates to how agencies are funded and to what ends. A mix of Federalism, home rule, and happenstance has contributed to a siloed funding system in the United States, whereby health agencies are given particular dollars for particular tasks. Little discretionary funding remains. Furthermore, tracking how …

Differences In Work Environment For Staff As An Explanation For Variation In Central Line Bundle Compliance In Intensive Care Units., Yuna S.H. Lee, Patricia W. Stone, Monika Pogorzelska-Maziarz, Ingrid M. Nembhard

College of Nursing Faculty Papers & Presentations

BACKGROUND: Central line-associated bloodstream infections (CLABSIs) are a common and costly quality problem, and their prevention is a national priority. A decade ago, researchers identified an evidence-based bundle of practices that reduce CLABSIs. Compliance with this bundle remains low in many hospitals.

PURPOSE: The aim of this study was to assess whether differences in core aspects of work environments-workload, quality of relationships, and prioritization of quality-are associated with variation in maximal CLABSI bundle compliance, that is, compliance 95%-100% of the time in intensive care units (ICUs).

METHODOLOGY/APPROACH: A cross-sectional study of hospital medical-surgical ICUs in the United States was done. …